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[Current developments in the laboratory diagnosis of rubella]
1Laboratoires Réunis, Kutter-Lieners-Hastert, Institut für Med. Virologie, Zentrum der Hygiene, Universitätskliniken Frankfurt.
Bulletin De La Societe Des Sciences Medicales Du Grand-Duche De Luxembourg
|January 1, 1997
Summary
Laboratory diagnosis of rubella virus infection is highly reliable using ELISA tests for detecting IgG and IgM antibodies. Differentiating primary infections from reinfections, crucial in pregnancy, relies on antibody avidity or immunoblotting.
Area of Science:
- Virology
- Immunology
- Diagnostic Microbiology
Context:
- The hemagglutination inhibition assay (HAI) has been the reference standard for rubella diagnosis for 30 years.
- Enzyme-linked immunosorbent assays (ELISAs) are now widely used for rapid detection of rubella-specific IgG and IgM antibodies.
- Despite advancements, challenges remain in assay standardization and specificity.
Purpose:
- To review the current state of laboratory diagnosis for rubella virus infection.
- To highlight the strengths and limitations of various diagnostic methods, including serology and molecular techniques.
- To discuss the importance of accurate diagnosis, particularly in pregnant women and for congenital rubella syndrome.
Summary:
- ELISAs are the mainstay for routine rubella diagnosis, offering speed and ease compared to HAI, though inter-assay correlation for IgG quantification is poor.
- Serological methods remain crucial for acquired and congenital rubella diagnosis, with antibody avidity or immunoblotting essential for differentiating primary infections from reinfections in pregnancy.
- While anti-rubella IgM ELISAs show good sensitivity, potential cross-reactivity with other viruses necessitates careful interpretation. Congenital rubella syndrome due to maternal reinfection is rare but can be misdiagnosed.
Impact:
- Improved understanding of rubella diagnostic methodologies and their clinical utility.
- Highlights the need for better standardization of ELISA assays for rubella IgG quantification.
- Emphasizes the critical role of serological testing in managing rubella infections, especially during pregnancy, to prevent congenital rubella syndrome.