At a glance
Also known as
Why get tested?
To diagnose a measles or mumps infection; to establish whether a person has to measles or mumps due to a previous infection or to ; to confirm a measles or mumps case and investigate its source
When to get tested?
When a person has symptoms or complications that their doctor suspects are due to a measles or mumps infection; whenever it is necessary or desired to determine measles or mumps immunity
A blood sample drawn from a vein in your arm for measles or mumps antibody testing; to detect the virus itself, sample may be blood, urine, nasopharyngeal aspirate/washing, throat swab, swab of the inside of the cheek (buccal swab), , or other body tissue
Test preparation needed?
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
What is being tested?
Measles (rubeola) and mumps are members of the Paramyxoviridae family of . They both cause illnesses in children throughout the world that are preventable through . Vaccination has drastically reduced the number of people affected by measles in Australia 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 in many parts of the world.
Data from the Australian Institute of Health and Welfare Mortality database show that in the 1930s around 1,000 deaths each year were caused by measles. By 2000 this had dropped to zero because of measles vaccination. However, in more recent years measles has staged a comeback due to less comprehensive vaccination coverage in Australia.
In 2011 in Europe, an outbreak of measles led to the reporting of 6,500 cases from 33 countries. Because of the risk of travellers, both visitors and returning Australians spreading measles, outbreaks such as this are a concern for health authorities in Australia.
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 per cent develop complications that commonly include an ear infection, bronchitis, pneumonia or diarrhoea. Rarely (in 1 in a 1,000 infections) the brain is infected, often resulting in death or disability. People who are malnourished, have a vitamin A deficiency, or have 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.
Natural infection with measles rarely can cause a degenerative brain disease which can present many years after infection called subacute sclerosing panencephalitis. This condition progresses over 1-2 years and is always fatal. The overall mortality rate from measles in developed countries is approximately 2 in 1,000 persons.
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 in the blood or, less commonly, the detection of the mumps or measles virus in a . Reverse-transcriptase (RT-PCR) testing may be performed to confirm and investigate the source of measles infections. RT-PCR is faster and more sensitive than viral culture if performed on respiratory swab specimens. This testing is used to detect the measles virus and determine its genetic strain. 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 PCR while later in the infection, testing for antibodies 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 or to detect the itself. Antibody testing requires a blood sample, obtained by inserting a needle into a vein in the arm. Viral RT-PCR 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), , 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 tear. 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.
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. However, this may not be possible due to pain in the inflamed parotid gland. For other specimens, no test preparation is needed.