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Epic Test Code LAB161 Mumps Virus Antibody, IgM and IgG, Serum

Additional Codes

MML Code: MMPGM

LIS Code: MUMP

NY State Approved

Yes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Reporting Name

Mumps Ab, IgM and IgG, S

Method Name

MMPM: Enzyme Immunoassay (EIA)

MPPG: Multiplex Flow Immunoassay

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  14 days


Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.


Specimen Type

Serum

Specimen Minimum Volume

0.9 mL

Reference Values

IgM:

Negative: Index value 0.00-0.79

Reference value applies to all ages.

 

IgG:

Vaccinated: Positive (≥1.1 AI)

Unvaccinated: Negative (≤0.8 AI)

Reference values apply to all ages.

Report Available

1 to 7 days

Day(s) Performed

MMPM: Tuesday

MPPG: Monday through Saturday

CPT Code Information

86735-Mumps, IgG

86735-Mumps, IgM

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Heat-inactivated specimen Reject

Useful For

Diagnosis of mumps virus infection

 

Determination of postimmunization immune response of individuals to the mumps vaccine

 

Documentation of previous infection with mumps virus in an individual with no previous record of immunization to mumps virus

Profile Information

Test ID Reporting Name Available Separately Always Performed
MMPM Mumps Ab, IgM, S Yes Yes
MPPG Mumps Ab, IgG, S Yes Yes

Clinical Information

The mumps virus is a member of the Paramyxoviridae family of viruses, which include parainfluenza virus serotypes 1-4, measles, respiratory syncytial virus, and metapneumovirus. Mumps is highly infectious among unvaccinated individuals and is typically transmitted through inhalation of infected respiratory droplets or secretions. Following an approximate 2-week incubation period, symptom onset is typically acute with a prodrome of low-grade fever, headache, and malaise.(1,2) Painful enlargement of the salivary glands, the hallmark of mumps, occurs in approximately 60% to 70% of infections and in 95% of patients with symptoms. Testicular pain (orchitis) occurs in approximately 15% to 30% of postpubertal men and abdominal pain (oophoritis) is found in 5% of postpubertal women.(1) Other complications include mumps-associated pancreatitis (<5% of cases) and central nervous system disease (meningitis <10% and encephalitis <1%).

 

Widespread routine immunization of infants with attenuated mumps virus has dramatically decreased the number of reported mumps cases in the United States. However, outbreaks continue to occur, indicating persistence of the virus in the general population.

 

Laboratory diagnosis of mumps is typically accomplished by detection of IgM- and IgG-class antibodies to the mumps virus. However, due to the widespread mumps vaccination program, in clinically suspected cases of acute mumps infection, serologic testing should be supplemented with virus isolation in culture or detection of viral nucleic acid by polymerase chain reaction testing in throat, saliva, or urine specimens.

Interpretation

A positive IgG result coupled with a positive IgM result suggests recent infection with mumps virus. This result should not be used alone to diagnose mumps infection and should be interpreted in the context of clinical presentation.

 

A positive IgG result coupled with a negative IgM result indicates previous vaccination to or infection with mumps virus. These individuals are considered to have protective immunity to reinfection.

 

A negative IgG result coupled with a negative IgM result indicates the absence of prior exposure to mumps virus and nonimmunity. However, a negative result does not rule-out mumps infection or response to vaccination. The specimen may have been collected before the appearance of detectable antibodies. Negative results in suspected early mumps infection or within a week following vaccination should be followed by testing a new serum specimen in 2 to 3 weeks.

 

Equivocal results should be followed up with testing of a new serum specimen within 10 to 14 days.

Cautions

Serum specimens obtained during the acute phase of infection or soon after vaccination may be negative for IgM- or IgG-class antibodies by serological tests.

 

All positive IgM results must be interpreted cautiously as some false-positive results or heterotypical responses of the IgM have been seen in the serum of pregnant women or in patients with an acute infection caused by cytomegalovirus, herpes simplex virus, measles, rubella, or parvovirus.

 

Testing for IgM-class antibodies to mumps virus should be limited to patients with a clinically compatible disease.

 

Mumps virus shares antigenic relationships with other viruses of the paramyxovirus group; therefore, serologic cross-reactions are possible, but uncommon, with this test procedure.

 

Immunoglobulin G-class antibodies to mumps virus may be present in serum specimens from individuals who have received blood products within the past several months but have not been immunized or experienced past infection with this virus.

Supportive Data

IgM:

The SeraQuest mumps IgM kit showed a sensitivity of 97.3% and a specificity of 96.6% when 160 specimens were tested in parallel with a reference method.(Package insert: SeraQuest)

 

IgG:

To evaluate the accuracy of the BioPlex Mumps IgG multiplex flow immunoassay (MFI), 500 prospective serum specimens were analyzed in a blinded fashion by the SeraQuest Mumps IgG enzyme immunoassay (EIA) and the BioPlex Mumps IgG assay. Specimens with discordant results after initial testing were repeated by both assays during the same freeze/thaw cycle. Further discrepancies were evaluated by the Mumps IgG VIDAS enzyme-linked fluorescent immunoassay (ELFA; bioMerieux, Inc). The results are summarized below:

 

 

SeraQuest Mumps IgG EIA

BioPlex Mumps IgG

 

Positive

Negative

Equivocal

Positive

412

4(a)

8

Negative

3(b)

48

3

Equivocal

5

6

11

 

(a) All 4 samples tested positive by VIDAS Mumps IgG ELFA

(b) One of 3 samples tested negative by the VIDAS Mumps IgG ELFA

Sensitivity: 98.1% (412/420); 95% CI: 96.2%-99.1%

Specificity: 82.8% (48/58); 95% CI: 70.9%-90.6%

Overall percent agreement: 94.2% (471/500); 95% CI: 91.8%-96.0%

Specimen Retention Time

14 days

Forms

If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.