Measles and rubella laboratory network
The Global Measles and Rubella Laboratory Network (GMRLN) was developed based on the successful model of the Global Polio Laboratory Network. As of 2026, more than 760 laboratories have been established to serve 190 Member States. Many of these laboratories are also responsible for laboratory-based surveillance of other vaccine preventable diseases in their countries.
Measles case confirmation is based on laboratory evidence of acute infection, through detection of measles-specific IgM antibody in serum and/or measles virus RNA by reverse transcription real-time polymerase chain reaction (RT-qPCR). A single serum sample collected within 28 days of rash onset at first contact with a health care provider is sufficient for serological confirmation; most national laboratories use standardized, validated EIA IgM assays, with results available within 3-4 hours. As IgM may not yet be detectable in the first 0–3 days after rash onset, an early sample that tests negative for IgM should be repeated if there is indeed a suspicion of measles. In low-incidence and elimination settings, where the positive predictive value of IgM declines, RT-qPCR is increasingly used alongside or in preference to serology. RT-qPCR is most sensitive when a respiratory specimen, oral fluid or urine is collected within approximately one week of rash onset. These specimen types also permit genetic characterization of the virus; wherever possible, viruses are collected from cases and outbreaks, and their sequencing, in conjunction with epidemiological data, helps determine transmission patterns.
Rubella surveillance is often integrated with measles surveillance as the WHO measles case definition also captures rubella cases. Many countries administering rubella vaccine also take advantage of the combination vaccine presentation of measles and/or mumps. The confirmation of rubella cases is very similar to measles. The standard procedure recommends use of an IgM EIA assay performed on a single serum sample; RT-PCR is used for genotype characterization of the virus. Most countries follow a procedure of testing measles negative samples for rubella. Rubella virus detection is more challenging than for measles, but when successful, sequence information can be utilized for the same molecular epidemiological purposes as for measles.
Resources
Genotyping
Measles Genotyping
WER 2 March 2012, Vol 87, 9
Measles virus nomenclature update: 2012
WER 8 December 2006, 81, 51/52
Global distribution of measles and rubella genotypes – update
WER 7 October 2005, Vol 80, 40
New genotype of measles virus and update on global distribution of measles genotypes
WER 4 July 2003, Vol 78, 27
Update of the nomenclature for describing the genetic characteristics of wild-type measles viruses: new genotypes and reference strains
WER 28 August 1998, Vol 73, 35
Standardization of the nomenclature for describing the genetic characteristics of wild-type measles viruses
WER 17 August 2001, Vol 76, 33
Nomenclature for describing the genetic characteristics of wild-type measles viruses (update) – Part II
WER 10 August 2001, Vol 76, 32
Nomenclature for describing the genetic characteristics of wild-type measles viruses (update)
Rubella genotype
Rubella virus nomenclature update : 2013
WER 9 August 2013, Vol 88, 32 [pdf, 1.22Mb]
Update of standard nomenclature for wild-type rubella viruses, 2007
WER 15 June 2007, Vol 82, 24 [pdf, 726kb]
Rubella genetic information
WER, 15 June 2007, Vol 82, 24
Update of standard nomenclature for wild-type rubella viruses, 2007
WER 8 April 2005, Vol 80, 14
Standardization of the nomenclature for genetic characteristics of wild-type rubella viruses
Standardization of the nomenclature for generic characteristics of wild-type rubella viruses
(including graphics and references) [pdf, 464kb]