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Chapter 14: Rubella Figure 1

Figure 1

 

Figure 1. Algorithm for serologic evaluation of pregnant women exposed to rubella

Figure 1. Algorithm for serologic evaluation of pregnant women exposed to rubella

Text version

IgM and IgG at the time of first visit (Save sera)

  • IgM+/IgG+
    • Acute infection or false IgM positive
      • Collect 2nd serum 5-10 days later. IgM, IgG and avidity testing to be conducted
        • High avidity, no rise in IgG titers (tested together with first serum) Likely false-positive
        • Low avidity, rise in IgG titers (tested together with first serum) Acute Infection
          • Discuss options for pregnancy outcome
  • IgM+/IgG-
    • Acute infection or false IgM positive
      • Collect 2nd serum 5-10 days later. IgM, IgG and avidity testing to be conducted
        • High avidity, no rise in IgG titers (tested together with first serum) Likely false-positive
        • Low avidity, rise in IgG titers (tested together with first serum) Acute Infection
          • Discuss options for pregnancy outcome
  • IgM-/IgG-
    • Susceptible
      • Repeat IgM/IgG 3-4 weeks from suspected exposure (Test concurrently with first specimen)
        • Positive IgM+, IgG+
          • Acute Infection
            • Discuss options for pregnancy outcome
        • Negative
          • Repeat IgM/IgG in 6 weeks if risk of exposure continues to exist (Test concurrently with first specimen)
            • Positive IgM+, IgG+
              • Acute Infection
                • Discuss options for pregnancy outcome
            • Negative
              • Infection Discarded
  • IgM-/IgG+
    • Immune

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