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Measles (Rubeola) PCR, Throat Swab or Urine
Methodology: 
PCR

Testing Laboratory: 
State Hygienic Laboratory at the University of Iowa; Coralville, IA

Laboratory Section: 
Referral Testing

Interpretive Data: 
Case Investigation
Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider report. Measles is an immediately reportable disease.
Call the reporting number for IDPH Center for Acute Disease Epidemiology (CADE) at (800) 362-2736 immediately upon identifying a suspect measles case.
After completing the investigation and gathering case information, enter the information into the Iowa Disease Surveillance System (IDSS), or FAX the report form with supporting laboratory documentation to (515) 281-5698 or mail (in an envelope marked “Confidential”) to the IDPH/CADE, mailing address:

Iowa Department of Public Health, CADE
Lucas State Office Building, 5th Floor
321 E. 12th St.
Des Moines, IA 50319-0075

Laboratory Testing Services Available
Suspect measles cases should be reported immediately to the Iowa Department of Public Health, Center for Acute Disease Epidemiology (CADE) at (800) 362-2736 or after hours, 515-323-4360. At that time, CADE will consult on appropriate testing to be ordered and specimen transport to the State Hygienic Laboratory (SHL). Public health response should not be delayed pending the return of laboratory results.

Measles (Rubeola) PCR, Throat Swab or Urine
Collection Information: 
A throat swab is preferred. Nasal/NP swabs or washes are acceptable but not preferred.

Throat swab: Swab tonsillar areas and posterior nasopharynx. Use tongue blade to depress tongue to prevent contamination of swab with saliva. Place swab into 2-3 ml of viral transport media. 

Urine specimen: Collect 10-40 ml of urine in a sterile urine specimen container. Have patient void directly into container, collecting from the first part of the urine stream if possible. First-morning voided specimens are ideal, but any urine collection is adequate.

Appropriate swabs and media:
Dacron swabs, flocked swabs
Viral transport medium (VTM)

Transport Information: 
Send refrigerated and ship on ice packs.

Remarks: 
Specimens for measles PCR should be obtained within five days of rash onset (0-9 days max). Viral RNA is more likely to be detected when the specimen is collected as soon as possible after rash onset.

Specimen Types Vary:
On day 0-5 of rash, collect a throat swab*
On day 6-9 of rash, collect a throat swab and a urine specimen**

*If a throat swab cannot be collected, a nasopharyngeal specimen can be sent instead; however, a throat swab is the preferred specimen IF case is clinically compatible and reports an exposure to measles or has had recent travel, attempt collection of all three specimens (throat, nasal and urine).
**If date of specimen collection is already more than nine days past rash onset, PCR is not valid.

Unacceptable Conditions: 
Wood-tipped applicators, Cotton-tipped swabs, Calcium-alginate tipped swabs, Charcoal swabs, Gel swabs. Dry swabs are not acceptable

Stability
Refrigerated Stability: 
Acceptable

Measles (Rubeola) PCR, Throat Swab or Urine
Sunquest Order Code: 
MSLAB

Epic Number: 
LAB2607

CPT Code: 

If an epidemiological investigation by IDPH, no charge for testing

Measles (Rubeola) PCR, Throat Swab or Urine
Modified: 
1/1/0001 12:00:00 AM