Mumps Antibodies - IgM

Measles (rubeola) and mumps are members of the Paramyxoviridae family of viruses. They both cause illnesses in children throughout the world that are preventable through vaccination. Vaccination has drastically reduced the number of people affected by measles in the UK and in many parts of the world, but the World Health Organization (WHO) still lists measles as a leading cause of death in young children. According to their estimates, measles affects more than 20 million people a year and is responsible for close to 200,000 deaths, primarily in children under the age of five. These numbers take into account efforts that led to the vaccination of 576 million children in high risk countries from 2000 to 2007 and a corresponding decrease in the number of measles deaths by 74% during the same time period. Mumps, a milder illness, is not as widely vaccinated against and is still endemic in many parts of the world.

Measles, also called rubeola, is an extremely contagious viral infection that is transmitted through respiratory secretions. The virus infects cells in the lungs and at the back of the throat and causes symptoms such as a high fever, dry cough, red eyes, light sensitivity, a runny nose, sore throat, tiny white spots inside the mouth, and a characteristic rash that typically starts on the face and spreads down the body to the trunk and legs. Most people recover within a couple of weeks, but up to 20% develop complications that may include an ear infection, bronchitis, pneumonia, diarrhoea, encephalitis, or blindness. People who are malnourished, have a vitamin A deficiency, or have compromised immune systems are frequently more severely affected. Women who are pregnant when they are infected with measles are at a greater risk of miscarriage or of premature labour.

Mumps is a viral infection that is transmitted through respiratory secretions or saliva. After a 2 to 3 week incubation period, an infected person typically develops flu-like symptoms such as a headache, muscle aches, and fever that are followed by characteristic parotitis – swelling of the salivary (parotid) glands below one or both ears. For most people, mumps is a mild, self-limited illness, but some may develop complications such as deafness, inflammation of the testicles (orchitis) or ovaries (oophoritis), pancreatitis, meningitis, or encephalitis.

Measles (rubeola) and mumps testing involves the detection of antibodies in the blood or, less commonly, the detection of the mumps or measles virus in a culture. Real-time polymerase chain reaction (RT-PCR) testing may be performed to confirm and investigate the source of measles infections. This testing is used to detect the measles virus and determine its genetic strain. Less commonly, RT-PCR mumps testing may also be performed. The choice of test is dependent on the stage of illness in which the affected person is seen. For example, early in the infection, the test of choice may be detection of the virus by culture or PCR while later in the infection, testing for antibody provides the most reliable result.

How is the sample collected for testing?

The sample required depends on whether testing is being done to determine the presence of antibody or to detect the virus itself. Antibody testing requires a blood sample, obtained by inserting a needle into a vein in the arm. Viral culturing or viral RNA RT-PCR molecular tests may be performed on a variety of samples, including blood, urine, nasopharyngeal aspirate/washing, throat swab, a swab of the inside of the cheek (buccal swab), cerebrospinal fluid, or other body tissue.

A nasopharyngeal swab is collected by having you tip your head back and then a Dacron swab (like a long Q-tip with a small head) is gently inserted into one of your nostrils until resistance is met. It is left in place for several seconds, then rotated several times to collect cells, and withdrawn. This is not painful, but it may tickle a bit and cause your eyes to water. For a nasal aspirate, a syringe is used to push a small amount of sterile saline into your nose and then gentle suction is applied to collect the resulting fluid.

In order to fully evaluate a suspected measles case, the CDC recommends the collection of blood as well as samples for culture and RT-PCR testing.

Is any test preparation needed to ensure the quality of the sample?

Prior to collection of a buccal swab for mumps, the salivary gland located in front of and below the ear (parotid gland) is massaged. For other specimens, no test preparation is needed.