风疹

这个项目主要是检测血中的风疹病毒抗体。风疹病毒抗体是机体针对风疹病毒感染反应而产生的。风疹病毒抗体有两类：IgM和IgG。风疹病毒感染后首先出现的是IgM型风疹病毒抗体。病毒感染后，血液中抗风疹病毒IgM抗体逐渐升高，于7到10天达到顶峰；在接下来的几周里逐渐降低；但是在被感染的新生儿体内IgM抗体可存在数月甚至一年。IgG型风疹病毒抗体比IgM抗体出现稍晚，但是这种抗体一旦出现就会一直在血液循环中存在，并保护机体的免受再次感染。血液中IgM型风疹病毒的存在可以提示新近的感染，而IgG型抗体的存在则可以提示新近或以往风疹病毒的感染，或者是曾经注射过风疹疫苗（麻疹、腮腺炎、风疹疫苗），同时也提示机体可以受到充分的保护。

风疹病毒通常引起一种轻度感染，这种感染以面部和颈部出现细小的红皮疹为特征，皮疹随后转移到躯干和四肢并在几天后消退。病毒来自于鼻咽部分泌物，可以引起一系列症状比如发烧、淋巴结肿大、鼻漏、红眼病和关节疼痛。症状可能非常轻，尤其是在儿童，病毒感染初期不易被发现。大多数患者，在不接受任何针对性治疗的情况下机体也能在几天内清除风疹病毒，不会引发其他疾病。人们最初关注到风疹病毒的感染是由于一位怀孕妇女在孕期的头三个月里首次感染此病毒。发育中的胎儿在这段时间里对病毒是非常敏感的，如果母亲将此病毒传染给胎儿，就会引发流产、死胎和/或先天性风疹综合征（CRS）—— 一组终生影响孩子的严重出生缺陷。CRS可以引起发育延缓、智力低下、耳聋、白内障、小头畸形、肝脏疾病和心脏缺陷。

由于风疹感染对胎儿发育可造成严重后果，1969年开始，美国首先在全国范围内对本国的儿童进行免疫以防止风疹病毒的感染，随后推广到全世界。在这之前，风疹病毒的感染呈周期性爆发且可持续数年。根据疾病预防和控制中心（CDC）的报告，在1962年-1965年流行期间，美国出现12,500,000例风疹病毒感染，有20,000名新生儿伴有CRS。由于疫苗接种的有效性，患者的数量大大下降。2006年，美国仅有11例患者感染风疹病毒的纪录，且其中一半的患者不是在美国出生的（这些国家没有广泛实施人群的疫苗接种计划）。从2001年以后，每年病例的报告都少于25例。目前CDC宣布美国已彻底消除了风疹病毒，但是对其发病率仍进行持续监测。但是CDC告诫人们不要因为这种疾病发病率下降而放松警惕，儿童仍然需要接种风疹病毒疫苗。没有接种疫苗的儿童（包括一部分接种过疫苗的）容易感染风疹病毒。

成人通过前臂静脉采血获得血样，新生儿通过脚后跟针刺采血或脐带采血获得血样。

不需要。

疾病: Traveler病
筛查: 妊娠: 风疹（德国麻疹）的免疫

Centers for Disease Control and Prevention: Rubella
March of Dimes: Rubella
Familydoctor.org: Rubella (German Measles)

Sources Used for Current Review

Hirsch, Lisa. Rubella (German Measles). (Reviewed July 2006). Familydoctor.org. Available online at http://www.kidshealth.org/PageManager.jsp?dn=familydoctor&lic=44&article_set=22917 through http://www.kidshealth.org. Accessed April 2008.

Averhoff F, et al. Adequacy of surveillance to detect endemic rubella transmission in the United States. Clin Infect Dis. 2006; 43 Suppl 3:S151-7. Available online at http://www.medscape.com/medline/abstract through http://www.medscape.com. Accessed April 2008.

(July 9, 2007) Mayo Clinic Staff. Rubella. MayoClinic.com. Available online at http://www.mayoclinic.com/health/rubella/DS00332/DSECTION=1 through http://www.mayoclinic.com. Accessed April 2008.

(June 20, 2007) Centers for Disease Control and Prevention. Traveler’s Health: Yellow Book, Chapter 4: Prevention of Specific Infectious Diseases, Rubella. Available online at http://wwwn.cdc.gov/travel/yellowBookCh4-Rubella.aspx through http://wwwn.cdc.gov. Accessed April 2008.

Jin L, Thomas B. Application of molecular and serological assays to case based investigations of rubella and congenital rubella syndrome. J Med Virol. 2007; 79(7):1017-24. Available online at http://www.medscape.com/medline/abstract/17516526 through http://www.medscape.com. Accessed April 2008.

(Updated May 2007) Centers for Disease Control and Prevention. Guidelines for Vaccinating Pregnant Women. Available online at http://www.cdc.gov/vaccines/pubs/preg-guide.htm#rubella through http://www.cdc.gov. Accessed online April 2008.

Centers for Disease Control and Prevention. MMWR (March 21, 2008) 51(53). Summary of Notifiable Diseases - United States 2006. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5553a1.htm through http://www.cdc.gov. Accessed online April 2008.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO., pp 751-752.

(© 2005). Rubella Antibodies, IgG and IgM. ARUP's Guide to Clinical Laboratory Testing. Available online at http://www.arup-lab.com/guides/clt/tests/clt_192b.jsp#1147292 through http://www.arup-lab.com.

Ben-Joseph, E. (2003 October, Reviewed). Rubella (German Measles). Familydoctor.org. Available online at http://www.kidshealth.org/PageManager.jsp?dn=familydoctor&lic=44&article_set=22917 through http://www.kidshealth.org

CDC (2005). Achievements in Public Health: Elimination of Rubella and Congenital Rubella Syndrome - United States, 1969-2004. Medscape, from MMWR. 2005; 54 (11): 279-282. Available online at http://www.medscape.com/viewarticle/501956 through http://www.medscape.com

A.D.A.M. editorial, Reviewed (2003 September 26, Reviewed). Previously reviewed by Adam Ratner. Rubella. MedlinePlus Medical Encyclopedia. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001574.htm through http://www.nlm.nih.gov/medlineplus/encyclopedia.html

Mayo Clinic Staff (2004 June 16). Rubella. MayoClinic.com. Available online at http://www.mayoclinic.com/invoke.cfm?id=DS00332 through http://www.mayoclinic.com

Stevens, L. (2002). Rubella. Medem Medical Library, JAMA Patient Page, from JAMA. 2002; 287:542. Available online at http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZV5AZLMWC&sub_cat=286 through http://www.medem.com

Hughes, H. and Wharton, M. (2002). K. Rubella. VPD Surveillance Manual, 3rd Edition, Chapter 19, Laboratory Support for the Surveillance of VPDs: 19-16. PDF available for download at http://www.cdc.gov/nip/publications/surv-manual/chpt19_lab_support.pdf through http://www.cdc.gov