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Test ID MMRV Measles, Mumps, Rubella, and Varicella (MMRV) Immune Status Profile, Serum

Reporting Name

MMRV Immune Status Profile, S

Useful For

Determining immune status of individuals to measles, mumps, rubella, and varicella-zoster viruses (VZV)


Documentation of previous infection with measles, mumps, rubella, or VZV in an individual without a previous record of immunization to these viruses

Profile Information

Test ID Reporting Name Available Separately Always Performed
ROPG Measles (Rubeola) Ab, IgG, S Yes Yes
MPPG Mumps Ab, IgG, S Yes Yes
RBPG Rubella Ab, IgG, S Yes Yes
VZPG Varicella-Zoster Ab, IgG, S Yes Yes

Specimen Type


Specimen Required


Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL

Specimen Minimum Volume

0.4 mL

Specimen Stability Information

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

Reference Values

Measles, Mumps and Varicella

Vaccinated: Positive (≥1.1 AI)

Unvaccinated: Negative (≤0.8 AI)

Reference values apply to all ages



Vaccinated: Positive (≥1.0 AI)

Unvaccinated: Negative (≤0.7 AI)

Reference values apply to all ages

CPT Code Information

86735-Mumps virus antibody, IgG

86762-Rubella antibodies, IgG

86765-Measles (rubeola) antibodies, IgG

86787-Varicella-Zoster antibody, IgG

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MMRV MMRV Immune Status Profile, S In Process


Result ID Test Result Name Result LOINC Value
VZG Varicella-Zoster Ab, IgG, S 15410-4
RBG Rubella Ab, IgG, S 40667-8
MUMG Mumps Ab, IgG, S 6476-6
ROG Measles (Rubeola) Ab, IgG, S 35275-7
DEXG3 Measles IgG Antibody Index 5244-9
DEXG2 Rubella IgG Antibody Index 5334-8
DEXG5 Mumps IgG Antibody Index 25418-5
DEXG4 Varicella IgG Antibody Index 5403-1

Clinical Information

The measles virus is a member of the Paramyxoviridae family of viruses, which include parainfluenza virus serotypes 1-4, mumps, respiratory syncytial virus (RSV), and metapneumovirus. The measles virus is among the most highly contagious infectious diseases among unvaccinated individuals and is transmitted through direct contact with aerosolized droplets or other respiratory secretions from infected individuals. Measles has an incubation period of approximately 8 to 12 days, which is followed by a prodromal phase of high fever, cough, coryza, conjunctivitis, and malaise. Koplik spots may also be apparent on the buccal mucosa and can last for 12 to 72 hours.(1) Following this phase, a maculopapular, erythematous rash develops beginning behind the ears and on the forehead and spreading centrifugally to involve the trunk and extremities.


Immunocompromised individuals, pregnant women, and those with nutritional deficiencies are particularly at risk for serious complications following measles infection, which include pneumonia and central nervous system (CNS) involvement.(1)


Following implementation of the national measles vaccination program in 1963, the incidence of measles infection has fallen to fewer than 0.5 cases per 1,000,000 individuals and the virus is no longer considered endemic in the United States. Measles outbreaks continue to occur in the United States due to exposure of nonimmune individuals or those with waning immunity to infected travelers. The measles outbreak in 2011 throughout Western Europe emphasizes the persistence of the virus in the worldwide population and the continued need for national vaccination programs.(2)


The diagnosis of measles infection is often based on clinical presentation alone. Screening for IgG-class antibodies to measles virus will aid in identifying nonimmune individuals.



The mumps virus is a member of the Paramyxoviridae family of viruses, which include parainfluenza virus serotypes 1-4, measles, RSV, and metapneumovirus. Mumps is highly infectious among unvaccinated individuals and is typically transmitted through inhalation of infected respiratory droplets or secretions. Following an approximately 2-week incubation period, symptom onset is typically acute with a prodrome of low-grade fever, headache, and malaise.(3,4) 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.(3) Other complications include mumps-associated pancreatitis (<5% of cases) and CNS 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 (PCR) in throat, saliva, or urine specimens.



Rubella (German or 3-day measles) is a member of the Togavirus family and humans remain the only natural host for this virus. Transmission is typically through inhalation of infectious aerosolized respiratory droplets and the incubation period following exposure can range from 12 to 23 days.(5) Infection is generally mild and self-limited, and is characterized by a maculopapular rash beginning on the face and spreading to the trunk and extremities, fever, malaise, and lymphadenopathy.(6)


Primary in utero rubella infections can lead to severe sequelae for the fetus, particularly if infection occurs within the first 4 months of gestation. Congenital rubella syndrome is often associated with hearing loss and cardiovascular and ocular defects.(7)


The United States 2-dose measles, mumps, and rubella (MMR) vaccination program, which calls for vaccination of all children, leads to seroconversion in 95% of children following the first dose.(5) A total of 4 cases of rubella were reported to the Centers of Disease Control and Prevention in 2011 without any cases of congenital rubella syndrome.(8) Due to the success of the national vaccination program, rubella is no longer considered endemic in the United States ( Immunity may, however, wane with age as approximately 80% to 90% of adults will show serologic evidence of immunity to rubella.


Varicella-Zoster Virus:

Varicella-Zoster virus (VZV), a herpes virus, causes 2 distinct exanthematous (rash-associated) diseases: chickenpox (varicella) and shingles (herpes zoster). Chickenpox is a highly contagious, though typically benign disease, usually contracted during childhood. Chickenpox is characterized by a dermal vesiculopustular rash that develops in successive crops approximately 10 to 21 days following exposure.(9) Although primary infection with VZV results in immunity and protection from subsequent infection, VZV remains latent within sensory dorsal root ganglia and upon reactivation, manifests as herpes zoster or shingles. During reactivation, the virus migrates along neural pathways to the skin, producing a unilateral rash, usually limited to a single dermatome. Shingles is an extremely painful condition typically occurring in older, nonimmune adults or those with waning immunity to VZV and in patients with impaired cellular immunity.


Individuals at risk for severe complications following primary VZV infection include pregnant women, in whom the virus may spread through the placenta to the fetus, causing congenital disease in the infant. Additionally, immunosuppressed patients are at risk for developing severe VZV-related complications, which include cutaneous disseminated disease and visceral organ involvement.


Serologic screening for IgG-class antibodies to VZV aids in identifying nonimmune individuals.


Positive measles, mumps, varicella-zoster viruses (VZV): Antibody Index (AI) value ≥1.1

Positive rubella: AI Value ≥1.0


The reported AI value is for reference only. This is a qualitative test and the numeric value of the AI is not indicative of the amount of antibody present. AI values above the manufacturer recommended cutoff for this assay indicate that specific antibodies were detected, suggesting prior exposure or vaccination.


The presence of detectable IgG-class antibodies to these viruses indicates prior exposure through infection or immunization. Individuals testing positive for IgG-class antibodies to measles, mumps, rubella, or VZV are considered immune.


Equivocal measles, mumps, VZV: AI value 0.9-1.0

Equivocal rubella: AI value 0.8-0.9


Submit an additional sample for testing in 10 to 14 days to demonstrate IgG seroconversion if recently vaccinated or if otherwise clinically indicated.


Negative measles, mumps, VZV: AI value ≤0.8

Negative rubella: AI value ≤0.7


The absence of detectable IgG-class antibodies to measles, mumps, rubella, or VZV suggests no prior exposure to these viruses or the lack of a specific immune response to immunization.

Clinical Reference

1. Perry RT, Halsey NA: The clinical significance of measles-a review. J Infect Diseases. 2004;189(Supp 1):S4-S16

2. Centers for Disease Control and Prevention (CDC): Increased transmission and outbreaks of measles-European Region, 2011. MMWR Morb Mortal Wkly Rep. 2011;60(47):1605-1610

3. Hviid A, Rubin S, Muhlemann K: Mumps. Lancet. 2008 Mar;371(9616):932-944

4. Hodinka RL, Moshal KL: Childhood infections. In: Storch GA, ed. Essentials of Diagnostic Virology. Churchill Livingstone; 2000; 168-178

5. American Academy of Pediatrics. Rubella. In: Pickering LK, ed. Red Book. Report of the Committee on Infectious Diseases. 2012

6. Best JM: Rubella. Semin Fetal Neonatal Med. 2007;12(3):182

7. Duszak RS: Congenital rubella syndrome-major review. Optometry. 2009;80(1):36

8. Notifiable diseases and mortality tables. MMWR Morb Mortal Wkly Rep. 2012;61(34):466-479

9. Yankowitz J, Grose C: Congenital infections. In: Storch GA, ed. Essentials of Diagnostic Virology. Churchill Livingstone; 2000; 187-201

Report Available

Same day/1 day

Method Name

Multiplex Flow Immunoassay (MFI)


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

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

Day(s) Performed

Monday through Saturday