As validated improvements or alternative methodologies become available for measles and rubella diagnostics, updates will be posted to the GMRLN website. Types of assays or techniques that show promise for expanding throughput or have specific utility in the field are described below:
Point of Contact Test (PoCT) for Measles IgM
Rapid (less than 30 minutes) tests based on Lateral flow technology are widely used for HIV and hepatitis diagnosis and screening. Recently an assay for detecting measles IgM has been described which has good sensitivity and specificity [18, 19]. These assays are designed to be read visually either in a clinic or by surveillance teams and as such give subjective results. Before they are implemented for measles diagnosis it is essential that training is provided and QA systems are established to monitor accuracy of the results produced. At the time of this writing, the assay is not yet commercially available.
Lateral flow rapid diagnostic tests (RDTs) capable of detecting measles-specific IgM antibodies represent a transformative technology for measles surveillance. These tests can be performed at ambient temperature in under thirty minutes, using serum or capillary blood (or potentially, oral fluid) specimens collected at or near the point of contact with the patient. Performed correctly, RDTs achieve sensitivity and specificity comparable to laboratory-based EIAs. RDTs with positive IgM results can also be dried and shipped at ambient temperature to national laboratories for viral RNA extraction and genotyping, supporting molecular epidemiology without separate reverse cold-chain specimen transport. Although rubella surveillance and testing are often integrated with measles, currently, as of late-2026, there are no validated and commercially available RDTs for rubella.
This document provides operational and laboratory guidance for the introduction and use of measles IgM RDTs within a country’s surveillance program. It is intended for epidemiologists, surveillance officers, laboratorians, and public health staff involved in measles case detection, outbreak investigation, and vaccination response. See Annex B14: Measles IgM Rapid Diagnostic Test Introduction - Interim Guidance for Use in Public Health Surveillance.
Novel platforms for seroprevalence studies
The GMRLN has been investigating the use of platforms other than EIA for seroprevalence and vaccination studies. These novel platforms allow high throughput testing for multiple antigens at reduced overall running costs. In particular, multiplex bead assays (MBA) have the ability to simultaneously detect IgG antibodies to measles and rubella in very small volumes of serum [20-22]. MBA assays are being developed for use in GMRLN laboratories to improve the uniformity of serologic testing for seroprevalence studies. Research assays using microfluidic systems have been described for measles, but had not reached the implementation stage for measles diagnostic services at the time of the manual preparation.