Mumps laboratory tests: Difference between revisions
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==Serology== | ==Serology== | ||
*Significant rise in [[IgG]] or [[IgM]] antibodies may be helpful to confirm the diagnosis. However, | *Significant rise in [[IgG]] or [[IgM]] antibodies may be helpful to confirm the diagnosis. | ||
*However, laboratory confirmation of mumps in previously vaccinated or previously infected individuals is challenging, and failure to detect [[IgM|mumps IgM]] in previously vaccinated persons has been well documented including the cross reactivity of mumps and parainfluenza viruses.<ref>{{cite web | url = http://www.cdc.gov/mumps/lab/qa-lab-test-infect.html | title = Mumps: Lab Testing for Mumps Infection | work = Centers for Disease Control and Prevention | date = 13 April 2010 | accessdate = 30 October 2011 }}</ref> | |||
:'''''Persons with a history of mumps vaccination may not have detectable mumps IgM antibody regardless of timing of specimen collection.'''''[http://www.cdc.gov/mumps/lab/overview-serology.html CDC] | |||
*The ability to detect [[IgM]] varies by vaccination status and is: | |||
:*highest in unvaccinated persons (80%–100%),<ref name="pmid3833873">{{cite journal |author=Sakata H, Tsurudome M, Hishiyama M, Ito Y, Sugiura A |title=Enzyme-linked immunosorbent assay for mumps IgM antibody: comparison of IgM capture and indirect IgM assay |journal=[[Journal of Virological Methods]] |volume=12 |issue=3-4 |pages=303–11 |year=1985 |month=December |pmid=3833873 |doi= |url= |accessdate=2012-03-13}}</ref> | |||
:*intermediate in one-dose vaccine recipients (60%–80%),<ref name="pmid8277201">{{cite journal |author=Briss PA, Fehrs LJ, Parker RA, Wright PF, Sannella EC, Hutcheson RH, Schaffner W |title=Sustained transmission of mumps in a highly vaccinated population: assessment of primary vaccine failure and waning vaccine-induced immunity |journal=[[The Journal of Infectious Diseases]] |volume=169 |issue=1 |pages=77–82 |year=1994 |month=January |pmid=8277201 |doi= |url=http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=8277201 |accessdate=2012-03-13}}</ref><ref name="pmid9801337">{{cite journal |author=Narita M, Matsuzono Y, Takekoshi Y, Yamada S, Itakura O, Kubota M, Kikuta H, Togashi T |title=Analysis of mumps vaccine failure by means of avidity testing for mumps virus-specific immunoglobulin G |journal=[[Clinical and Diagnostic Laboratory Immunology]] |volume=5 |issue=6 |pages=799–803 |year=1998 |month=November |pmid=9801337 |pmc=96204 |doi= |url=http://cvi.asm.org/cgi/pmidlookup?view=long&pmid=9801337 |accessdate=2012-03-13}}</ref> | |||
:*lowest in two-dose vaccine recipients (13%–14%)<ref name="pmid18184850">{{cite journal |author=Bitsko RH, Cortese MM, Dayan GH, Rota PA, Lowe L, Iversen SC, Bellini WJ |title=Detection of RNA of mumps virus during an outbreak in a population with a high level of measles, mumps, and rubella vaccine coverage |journal=[[Journal of Clinical Microbiology]] |volume=46 |issue=3 |pages=1101–3 |year=2008 |month=March |pmid=18184850 |pmc=2268349 |doi=10.1128/JCM.01803-07 |url=http://jcm.asm.org/cgi/pmidlookup?view=long&pmid=18184850 |accessdate=2012-03-13}}</ref><ref name="pmid21666213">{{cite journal |author=Rota JS, Hickman CJ, Sowers SB, Rota PA, Mercader S, Bellini WJ |title=Two case studies of modified measles in vaccinated physicians exposed to primary measles cases: high risk of infection but low risk of transmission |journal=[[The Journal of Infectious Diseases]] |volume=204 Suppl 1 |issue= |pages=S559–63 |year=2011 |month=July |pmid=21666213 |doi=10.1093/infdis/jir098 |url=http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=21666213 |accessdate=2012-03-13}}</ref> | |||
==Virus Isolation== | ==Virus Isolation== | ||
Revision as of 20:11, 13 March 2012
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Mumps Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
Laboratory testing for mumps virus can be useful, and may include virus isolation from swabs of affected salivary ducts, antigen detection by PCR, and serologic testing for IgM antibody or a significant rise in IgG antibody. However, there are many important caveats to be aware of when interpreting the results.[1]
Initial Lab Tests
Complete blood count with differential:
- Total WBC count may be normal to elevated
- Relative lymphocytosis may be observed
Serum studies:
- Elevated of serum amylase secondary to the involvment of parotid gland and suspected pancreatitis associated with mumps [2]
- Elevated serum lipase secondary to pancreatitis
- Elevated C-reactive protein may be seen secondary to orchitis
Serology
- However, laboratory confirmation of mumps in previously vaccinated or previously infected individuals is challenging, and failure to detect mumps IgM in previously vaccinated persons has been well documented including the cross reactivity of mumps and parainfluenza viruses.[3]
- Persons with a history of mumps vaccination may not have detectable mumps IgM antibody regardless of timing of specimen collection.CDC
- The ability to detect IgM varies by vaccination status and is:
- highest in unvaccinated persons (80%–100%),[4]
Virus Isolation
- Infected patients remain contagious approximately 6 days before the onset of parotitis until about 9 days after the onset of parotitis, during which time the virus can be isolated. [9]
- Virus can be isolated in a cell culture inoculated with the virus obtained from swabs of affected salivary ducts, serum or urine.
- Antigen detection by polymerase chain reaction (PCR) is reserved for patients with secondary CNS infection.
References
- ↑ "Mumps: Lab Testing for Mumps Infection". Centers for Disease Control and Prevention. 13 April 2010. Retrieved 30 October 2011.
- ↑ Skrha J, Stĕpán J, Sixtová E (1979). "Amylase isoenzymes in mumps". European Journal of Pediatrics. 132 (2): 99–105. PMID 499265. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ "Mumps: Lab Testing for Mumps Infection". Centers for Disease Control and Prevention. 13 April 2010. Retrieved 30 October 2011.
- ↑ Sakata H, Tsurudome M, Hishiyama M, Ito Y, Sugiura A (1985). "Enzyme-linked immunosorbent assay for mumps IgM antibody: comparison of IgM capture and indirect IgM assay". Journal of Virological Methods. 12 (3–4): 303–11. PMID 3833873. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Briss PA, Fehrs LJ, Parker RA, Wright PF, Sannella EC, Hutcheson RH, Schaffner W (1994). "Sustained transmission of mumps in a highly vaccinated population: assessment of primary vaccine failure and waning vaccine-induced immunity". The Journal of Infectious Diseases. 169 (1): 77–82. PMID 8277201. Retrieved 2012-03-13. Unknown parameter
|month=ignored (help) - ↑ Narita M, Matsuzono Y, Takekoshi Y, Yamada S, Itakura O, Kubota M, Kikuta H, Togashi T (1998). "Analysis of mumps vaccine failure by means of avidity testing for mumps virus-specific immunoglobulin G". Clinical and Diagnostic Laboratory Immunology. 5 (6): 799–803. PMC 96204. PMID 9801337. Retrieved 2012-03-13. Unknown parameter
|month=ignored (help) - ↑ Bitsko RH, Cortese MM, Dayan GH, Rota PA, Lowe L, Iversen SC, Bellini WJ (2008). "Detection of RNA of mumps virus during an outbreak in a population with a high level of measles, mumps, and rubella vaccine coverage". Journal of Clinical Microbiology. 46 (3): 1101–3. doi:10.1128/JCM.01803-07. PMC 2268349. PMID 18184850. Retrieved 2012-03-13. Unknown parameter
|month=ignored (help) - ↑ Rota JS, Hickman CJ, Sowers SB, Rota PA, Mercader S, Bellini WJ (2011). "Two case studies of modified measles in vaccinated physicians exposed to primary measles cases: high risk of infection but low risk of transmission". The Journal of Infectious Diseases. 204 Suppl 1: S559–63. doi:10.1093/infdis/jir098. PMID 21666213. Retrieved 2012-03-13. Unknown parameter
|month=ignored (help) - ↑ UTZ JP, HOUK VN, ALLING DW (1964). "CLINICAL AND LABORATORY STUDIES OF MUMPS". The New England Journal of Medicine. 270: 1283–6. doi:10.1056/NEJM196406112702404. PMID 14133666. Retrieved 2012-03-09. Unknown parameter
|month=ignored (help)