Enzyme Linked Immunosorbant Assay (ELISA) - IgM

Detection of IgM antibodies to the measles virus by enzyme linked immunosorbant assay (ELISA).

Serum or plasma (100 µL minimum) collected as soon as possible after rash onset, ideally within 7 days, and within 28 days of rash onset.

Collect blood in serum separator tubes (SST) or EDTA tubes.

Follow standard laboratory techniques to prepare serum or plasma. Store at 4°C and ship at room temperature or on wet ice for arrival at the NML within 3 days of collection. Otherwise, freeze (-20°C or below) and ship frozen on dry ice.

Shipping of specimens shall be done by a TDG certified individual in accordance with TDG regulations. For additional information regarding classification of specimens for the purposes of shipping, consult either Part 2 Appendix 3 of the TDG Regulations or section 3.6.2 of the IATA Dangerous Goods Regulations as applicable.

Suspected cases of measles. Refer to reference 2 for case definitions.

Completed Measles, Mumps, and Rubella requisition form.  Include date of rash onset, date of last measles vaccination (if recent), travel history and/or MARS identifier (from the Measles and Rubella Surveillance application on CNPHI) or case number as available.

Please contact the lab in advance of sending samples. The NML is a WHO/PAHO accredited Measles and Rubella Regional Reference Laboratory. In order to assist in case classification, the NML might also perform measles IgG or measles IgG avidity ELISA.

Testing is done using the Measles virus IgM  ELISA assay from Microimmune, or an equivalent commercial ELISA assay (1). A positive IgM result is indicative of an acute measles infection when rash was present and there is a history of exposure to measles through travel to an endemic area or an epidemiological link to a confirmed case. Refer to the Laboratory Guidelines for the Diagnosis of Measles in reference 2 for further information.

21 calendar days. Turnaround time can be as short as 3 calendar days, with proper notification.

1. Hiebert J, Zubach V, Charlton CL, Fenton J, Tipples GA, Fonseca K, Severini A. Evaluation of Diagnostic Accuracy of Eight Commercial Assays for the Detection of Measles Virus-Specific IgM Antibodies. J Clin Microbiol. 2021 May 19;59(6):e03161-20. doi: 10.1128/JCM.03161-20. PMID: 33731415.
2. Measles and Rubella Elimination Working Group, Health Canada, Public Health Agency of Canada. Guidelines for the prevention and control of measles outbreaks in Canada. CCDR. 2013; 39:ACS-3. Available at http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/13vol39/acs-dcc-3/index-eng.php#appa.
3. World Health Organization. Manual for the laboratory diagnosis of measles and rubella virus infection. Third edition. 2018. Available at  https://www.technet-21.org/en/topics/laboratory-measles-rubella-manual