Rubella diagnostic issues in Canada.

With the success of the rubella vaccination program, a goal for the elimination of rubella and congenital rubella syndrome (CRS) by 2010 has been established. To monitor the progress toward elimination, surveillance is critical. The laboratory plays an important role in both diagnostics and surveillance for rubella and CRS. In the elimination phase, there are particular issues and challenges that are important to consider when undertaking rubella diagnostics and surveillance activities. Although immunoglobulin (Ig) M serological testing is the primary diagnostic test used to confirm acute rubella infection, additional tests, such as paired IgG serological testing, molecular detection of rubella virus, and rubella IgG avidity testing need to be considered for confirming cases, depending on the clinical and epidemiologic context of a particular suspected rubella case.