Antibody test - measles (Morbillivirus )

A serological test (from the blood) for IgG antibodies against the Morbillivirus that causes the disease. The result is a determination of whether the person has a high enough level of antibodies to be considered as protection against the disease. The test is not designed to diagnose acute disease because IgG antibodies are only produced in the interval after immunisation or after the disease has been overcome. Immunisation in the population is by blanket vaccination with a vaccine (called MMR - morbilli, mumps, rubella). Persons proven to have survived measles are immune to further infection. The level of protective antibodies gradually decreases with age.

Professionally about measles vaccination

Since 1969, measles vaccination was compulsory in Czechoslovakia. Today, the MMR vaccine, which combines vaccination against three diseases: measles, mumps and rubella, is used in Slovakia. Preschool children are vaccinated according to the current vaccination schedule (3).

One dose of the MMR vaccine has:

•  93 % efficacy against measles,
• 78 % efficacy against mumps and
• 97% efficacy against rubella (14).

Two doses of the MMR vaccine have:

• 97 % efficacy against measles and
• 88% efficacy against mumps (4).

Some people, even if they have received two doses of the vaccine, can get measles, mumps or rubella. The symptoms are milder and the disease is also less likely to spread further (4). The fact that an individual can get measles despite vaccination is due to a gradual decline in the level of protective antibodies (IgG class). Their level decreases with age (4) (5):

• between the ages of 25 and 29 years by 2%,
• between 30 and 34 years of age by 14 %,
• between 35 and 39 years of age by 17 %,
• between the ages of 40 and 44 by 23% (6).

People who have overcome measles are immune to further infection.

Persons born before 1969, before the introduction of universal measles vaccination, are naturally immune.(4)(7)(8) Persons with positive measles-specific IgG antibodies are considered immune. Persons with borderline or negative findings of IgG antibodies are considered non-immune (8). In the case of a negative IgG antibody finding, subsequent (re-)immunisation with a combination vaccine may be performed (6).

We do not recommend entry of patients/clients with clinical signs of disease (temperature, cough, signs of respiratory tract infection, etc.) to undergo this test.
We recommend hand disinfection prior to entry to the clinics/collection points.

It is advised to fast for a minimum of 8 hours by refraining from eating or drinking anything expect water. Faiing to fast before the test may affect result quality. If you are currently on medications, consult your healtcare provider to determine whether you should continue taking them prior to the test.

PREPARATION FOR BLOOD COLLECTION
The recommended time to collect blood is between 7 a.m. and 9 a.m., to obtain comparable results from different blood draws. To assess the numerical test result, so-called reference intervals are used, which are based on morning fasting collections and are used for population comparison. This time interval is also recommended in light of the biological cycles that naturally take place in the body.

GENERAL PRE-SAMPLING INSTRUCTIONS
It is necessary to come to the testing site earlier, so that you can rest in the waiting room for approximately 20 minutes to have a relatively relaxed body and mind.
It is necessary to arrive on an empty stomach for the collection itself, in the case of collections at a later time in the day, at least three hours on an empty stomach. At home, it is desirable to drink a sufficient amount of pure water (at least up to half a liter) - this is important for a successful blood collection. Mineral water, juice, coffee and tea are not recommended.
Herbs included in tea may contain substances affecting the blood count. Coffee and black tea increase gastric acid production and release insulin from the pancreas, thereby affecting glucose metabolism. Since everything in the body is interrelated, they can impact other tests. Another extreme is when your body is running out of fluids. In this case, the number of red blood cells, the level of protein and lipids bound to the protein increase and the level of urea in the blood can also increase. It is therefore advisable to drink pure water when you wake up.

Generally, it is recommended to:
• around 6 p.m. eat only light meals, do not eat fatty food (cheese, butter, cream, meat, smoked meat, bacon) and sweet meals,
• fast for 10-12 hours (Attention: it is not advisable to starve for more than 16 hours!), in the case of later collection (after 9:30 a.m.), a lighter breakfast is allowed, no later than 3 hours before collection,
• drink non-alcoholic beverages and drinks without sugar in the usual quantity, in the case of adult clients 24 hours before blood collection (Alcohol in the blood changes lipid levels, the level of glucose is reduced, uric acid levels increase and liver enzymes are released into the blood),
• take only prescribed medicines in the evening,
• avoid increased physical activity, and strength and endurance exercise the day before blood collection (Lipid, glucose, some enzyme levels in the blood and other parameters may change during physical activity. The recovery of normal values to maintain the accuracy of laboratory results may take a longer time, depending on the duration of the exercise, your physical fitness in general and other factors. We recommend maintaining normal daily physical activity such as light stretching, short cycling to work, gardening, etc.),
• avoid psychological stress, which raises blood glucose levels and causes the release of stress hormones in particular,
• avoid smoking for at least 6 hours prior to blood collection because it increases the level of carbonylhemoglobin produced by the reaction of the blood dye with carbon monoxide and alters the permeability and elasticity of the vessels, affecting the ratios of blood analytes,
• do not chew gum for at least 6 hours before blood collection, as this may affect glucose and enzyme levels,
• do not undergo stressful diagnostic or therapeutic interventions for at least 24 hours prior to blood collection.
If any of the tests you have selected require special preparation, you will be informed of the fact by email with the order and blood collection instructions attached. These specific instructions have priority over the general recommendations for preparation.

MEDICINES
It is recommended to have blood collected before the planned doses of medicines. If it is not possible to take the medicine later, you should inform the nurse during blood collection and specify what medication you have taken.
Take the medicines prescribed by your doctor in the morning or bring them with you to take them after blood collection (thyroid medicines, antihypertensive medicines, blood thinners, contraceptives, etc.) In the case of later collection (after 9:30 a.m.), you can take the prescribed medication in the morning.
Do not take iron, vitamin, nutritional supplements or other supplements, including homeopathics, for at least three (3) days prior to blood collection.

SPECIFIC SITUATIONS
In order to obtain the appropriate answers to your questions with regard to the laboratory tests, it is important to accurately notify the nurse at the healthcare provider about the following facts prior to your blood test:
• regularly used medicines and supplements (ideally come with a written list to the blood collection site),
infectious diseases you suffer from (e.g., HIV, hepatitis, mononucleosis...),
• contact with an infected person or presence in an infectious environment,
• if you have received an infusion within the last 5 days, specify into which limb,
• intramuscular injections within 3 days prior to the blood collection date,
• long-term immobilisation, lost ability to move,
• activities at higher altitudes,
• allergy to common band-aids,
• if you feel unwell when looking at blood or needles, please also notify our blood collection staff of the fact.

OTHER FACTORS
Please note that prolonged use of medication or other important factors may affect the values measured by the tests you have selected. For more information, please see the description of the specific test. To obtain objective test results, take the time to properly prepare for your blood collection.

In case of purchasing the interpretation of the results, this interpretation is created by an internist from uLékaře.cz.

(1) Spalničky. NZIP.cz. Dostupné online na: https://www.nzip.cz/clanek/35-spalnicky. [cit. 01-15-2025].

(2) Laboratory testing for measles. (2024). Measles (Rubeola). Dostupné online na: https://www.cdc.gov/measles/php/laboratories/index.html. [cit. 01-15-2025].

(3) Vyhláška č. 537/2006 Sb., o očkování proti infekčním nemocem, ve znění pozdějších předpisů. [cit. 01-15-2025].

(4) Professional, C. C. M. (2024c). MMR vaccine. Cleveland Clinic. Dostupné online na: https://my.clevelandclinic.org/health/procedures/mmr-vaccine. [cit. 01-15-2025].

(5) Bianchi, F. P., Mascipinto, S., Stefanizzi, P., De Nitto, S., Germinario, C., & Tafuri, S. (2021). Long-term immunogenicity after measles vaccine vs. wild infection: an Italian retrospective cohort study. Human Vaccines & Immunotherapeutics, 17(7), 2078–2084. Dostupné online na: https://doi.org/10.1080/21645515.2020.1871296. [cit. 01-15-2025].

(6) BÍLKOVÁ FRÁNKOVÁ, H., KLOUDOVÁ, A., ZELENÁ, H., TOMÁŠKOVÁ, H., ŠEBÁKOVÁ, H., MARTINKOVÁ, I., MATLEROVÁ, Š., FRÁNOVÁ, D., Jílková, E., Král, V. a kol. Víceúčelový sérologický přehled (spalničky, příušnice, petruse, virová hepatitida B) SP 2013, ČR: Závěrečná zpráva, příloha č.1. ZPRÁVY CENTRA EPIDEMIOLOGIE A MIKROBIOLOGIE, SZÚ. 2014, roč. 23, s. 1-152. [cit. 01-15-2025].

(7) Limberková, MUDr. & SZÚ Praha, NRL pro zarděnky, spalničky, parotitidu a parvovirus B19. (n.d.). Spalničky: odběr, skladování a transport klinického materiálu, laboratorní diagnostika, historie očkování. In KLINICKÝ MATERIÁL [Report]. Dostupné online na: https://www.khsova.cz/docs/01_aktuality/files/spalnicky_postup_odber.pdf. [cit. 01-15-2025].

(8) SZU, N. Z. (n.d.). LABORATORNÍ DIAGNOSTIKA SPALNIČEK. Dostupné online na: https://archiv.szu.cz/uploads/Epidemiologie/Spalnicky/Algoritmus_laboratorni_diagnostiky_spalnicek.pdf. [cit. 01-15-2025].