New Telegraph 
Lassa fever has resurfaced yet again with a significant increase in deaths since January, according to reports, from the Nigeria Centre for Disease Control and Prevention (NCDC). It is hard to diagnose as its symptoms resemble those of malaria, typhoid and other viral haemorrhagic fevers. Isioma Madike reports.
Background/current statistics
Caused by rodents, the disease has been brutal in magnitude since its current outbreak. This is happening at a time the nation is grappling with an economic crisis that has created panic across the country.
Between January and March, Nigeria has experienced a significant eruption.
The Director-General of the NCDC, Dr Jide Idris, during a national health security briefing in Abuja on Friday, reaffirmed the agency’s commitment to safeguarding public health through timely, transparent, and accurate disease reporting.
He said surveillance and response efforts were ongoing in collaboration with state health authorities and partners to monitor disease trends and support affected states with rapid interventions.
He said: “Cumulatively, as of epidemiological week 16, Nigeria has recorded 4,253 suspected cases of Lassa fever, with 696 confirmed and 132 deaths, representing a case fatality rate of 19% per cent.”
He noted that while there has been a steady decline in Lassa fever cases in recent weeks, particularly in week 16 ending April 20, the risk remains high, especially in endemic areas.
“These improvements reflect the positive impact of surveillance, treatment, and community engagement. However, we must sustain and intensify our efforts,” he added.
The NCDC reported these suspected cases across 91 local government areas in 33 states. Unfortunately, 20 healthcare workers have been infected: 8 in Ondo, 4 in Bauchi, 1 in Edo, 2 in Taraba, 1 in Ebonyi, 2 in Gombe, 1 in Benue, and 1 in Ogun states.
Idris, said in an effort to respond and strengthen outbreak control, the agency had activated the Lassa Fever National Emergency Operations Centre (LF-EOC) at Response Level 2. This activation, he said, allows for improved coordination across all the stakeholders (Federal, States, Local Government, Developmental partners and others).
According to a statement from the Centre, signed by the Head, Corporate Communication, Sani Datti, the agency has distributed essential medical supplies, including Personal Protective Equipment (PPEs) and treatment medications, to affected states.
Also targeted, the statement added, is state-specific advisories, which have been issued to guide the prevention and control of the disease. He added that preventing Lassa fever requires collective action. While the NCDC and state governments are leading the response, every Nigerian has a role to play in reducing the spread of the virus.
The statement reads in part: “Despite these efforts, several challenges have hindered response efforts. These include weak community-level surveillance which impedes early detection, and inadequate human and financial resources for treatment, contact tracing, and active case search at both state and community levels.
“Furthermore, treatment centres are experiencing manpower shortages, and many patients delay seeking care, often resorting to self-medication and unorthodox practices, which ultimately prove ineffective.
Additionally, for the best outcomes, individuals suspected of having Lassa fever are advised to seek medical care immediately.
“The DG is appealing to state governments to support the cost of treatment for Lassa fever and similar diseases.
“In addition, he emphasised the critical role of the private sector in ensuring the provision of essential medical supplies and in supporting the public on health awareness initiatives.
“The agency reiterates the importance of healthcare workers consistently applying Infection Prevention and Control (IPC) measures and maintaining a high index of suspicion for Lassa fever.
“Finally, NCDC urges the citizens to be on top of their environmental hygiene practices and skills that prevent rats from accessing homes, food, and utensils. These remain the most effective means of prevention.”
Since January, Lassa Hemorrhagic Fever, an acute viral hemorrhagic fever caused by the natal multimammate mouse or rodent, the primary animal host of the Lassa virus, has rattled the health structures that were supposed to be on red alert.
Experts react
The health sector, at least in the estimation of ordinary citizens, has been caught off-guard yet again, just like it happened during the Ebola incident a few years back.
This may be the reason why some people have been insinuating that the health authorities’ and government’s ineptitude and unseriousness are to blame for the current epidemic.
But, to medical experts, clinically, Lassa infections are sometimes difficult to distinguish from other viral hemorrhagic fevers.
One of those with this opinion is a Professor of Public Health and Consultant Epidemiologist at the Lagos University Teaching Hospital (LUTH), Adebayo Onajole, who insisted that viruses of this nature usually surface once in a while.
“The problem is that it’s extremely difficult to distinguish it from other viral hemorrhagic fevers such as Ebola, Marburg and from more common febrile illnesses such as malaria.
“Most times, it comes like the normal fever and there is always a low index of suspicion and most people affected may not present clinical symptoms.
“Some may just have it and with related treatment, survive without presenting any serious suspicion. With our experience of the Ebola incident, the health authorities are now more alert to high index of suspicions towards certain clinical presentations of infections like we have now, otherwise it could have been worse than we are seeing.
“Having said that, the government needs to do more to strengthen the health sector, particularly at the local levels so as to be able to confront such malady effectively in future because clinically they would always resurface now and again.
“In any case, that does not mean we have to heap the blame on the government or the healthcare systems,” Onajole said.
A Chief Consultant Family Physician and former President, Commonwealth Medical Association (CMA), Dr Osahon Enabulele, also towed this line of argument.
He told Saturday Telegraph that he is at a loss as to where people are getting their views from concerning the lacklustre attitude of the health officials and government on the issue at hand.
The former Nigeria Medical Association (NMA), as well as ex-World Medical Association (WMA) President, further said: “The thing I know is that Lassa is not a new thing and the health authorities are alive to the challenge.
“What I think we should be talking about now is how to strengthen the health systems at the local level in terms of both primary and secondary structures. This is because an aggregate of that is what healthcare is supposed to be.
“In any case, we need to continue to emphasise research into these areas; this should have been the thinking since the Ebola saga. Given the fatality rate of the current Lassa, the Federal Government should not trade blame.
“Instead, it should step up effort like it’s already doing in terms of awareness, particularly at the grassroots and like I said earlier, move to fortify the local health system.
“We should not forget that this type of health challenge will always come and there ought to be a system in place to tackle such anytime there is recurrence. We should not be reacting like we are doing now but be proactive.
“When we do that, the rate of fatality would be minimal. Of course, from the current prevalence, nobody should be blamed for being panicky. That is my sincere contribution.”
Yet, Prof. Olurotimi Akinola, a Consultant Emergency Medicine Physician and former first Vice President, Society of Gynaecology and Obstetrics of Nigeria (SOGON), added another angle to the issue.
He said: “Nigeria is endemic to Lassa; it’s homegrown unlike Ebola, which was imported and much more deadly. I don’t think there has been any year without an outbreak of Lassa in the country and so we have been having it.
“This particular one may not have been more fatal, though it’s frightening. And because of the rising level of awareness from the Ebola incident, health managers have been able to curtail it thus far.
“It is difficult to generally eradicate the occurrence except when there is a vaccine for it. You can’t exterminate all the rats; that’s not possible. So, attention should be on getting the vaccine otherwise it will continue to recur. “
Former Chief Medical Director, Lagos State University Teaching Hospital (LASUTH), Ikeja, Dr Olufemi Olugbile, agrees with Akinola when he said that the disease is indigenous to Nigeria.
“It’s basically a wake-up call for both public health practitioners and the general public, especially in the area of hygiene that we habitually neglect. I won’t admit that the current epidemic took us unawares, rather I’d commend the public health sector for the speedy way they are combating it.
“It could have been worse but for their alertness.
“However, I would recommend that the government should intensify the consciousness campaign against filth; it should increase things that promote cleanliness. Lassa is simply an environmental problem,” he said.
Past Chair, Association of Public Health Physicians of Nigeria (Lagos), Doyin Odubanjo, is suggesting that the current outbreak of Lassa fever in Africa’s most populous nation should be declared a national health emergency because of its severity.
He said that it is serious enough given the worsening trend.
He added: “It has spread from just two states when it was first diagnosed in 1969 to 33 states in 2025. The situation has increasingly got worse over the years. And the numbers have continued to rise.”
On why people get infected and why it has been persistent, Odubanjo reaffirmed that Lassa fever is a viral haemorrhagic disease caused by the Lassa virus, which naturally infects the widely distributed house rat.
“It’s transmitted through the urine and droppings of infected rats found in most tropical and subtropical countries in Africa. They are able to contaminate anything they come in contact with.
“The Lassa virus spreads through human to human contact with tissue, blood, body fluids, secretions or excretions. This includes coughing, sneezing, kissing, sexual intercourse and breastfeeding.
“In hospitals the disease is spread through contaminated equipment. People become ill six to 21 days after they are infected. A fever is usually the first symptom followed by headaches and coughing, nausea and vomiting, diarrhoea, mouth ulcers and swollen lymph glands.
“Some patients also complain of muscle, abdomen and chest pains. And later, patients’ necks and faces swell and they bleed from their orifices and into their internal organs. Lassa fever can be fatal, but it can be treated if diagnosed early,” he said.
To successfully turn the tide, governments at the local, state and federal levels need to mount an extensive and sustained public Lassa fever prevention and control awareness programme, he said.
“States of the federation also need to establish functional isolation wards for the treatment of Lassa fever patients. It is also important to set up a mechanism for improving environmental sanitation in a sustained way throughout the country to reduce rodent population as well as rodent-human contact.
“Funds should also be provided for research into finding new drugs for Lassa fever treatment and the development of a Lassa fever vaccine,” Odubanjo added.
In line with the new thinking, the National Association of Resident Doctors (NARD) has called on the government to improve existing response mechanisms to ensure rapid response in cases of disease outbreaks in the country.
Also, former President of the association, Dr Muhammad Askira, decried the emergency response arrangement set up by the government to tackle outbreak of any epidemic of this nature.
Askira said that such outbreaks do not require ad hoc arrangements or committees; rather, there should be an existing strategy to cushion the effect in any emergency or epidemic situation.
According to him, it will, in no small way, reduce the death toll arising from such cases. He also recommended well-structured strategies from the local, state and Federal Government to ensure that prompt attention was given to such situations.
He said: “There should be on ground, at any given point, a well-structured strategic system, from the local to the Federal Government, from the primary healthcare level to tertiary healthcare, whereby the team is already on alert for prompt and effective response to this type of epidemic.
“We should not wait until there is an outbreak before we start rushing to address the epidemic. This involves a lot of logistics, which comes from the society, healthcare providers and the government itself.
“It can be in the form of financing, appropriate equipment and facilities, well and adequately trained manpower to handle suspected and confirmed cases. So, whenever these are not adequate or properly applied, we have pockets and periods of epidemic of this nature.”
Lassa fever history
First identified in 1969, the hemorrhagic fever caused by the Lassa virus can be transmitted via contact with urine, faeces and blood of a rodent, commonly known as the multimammate rat. Human to human transmission has also been found to be possible.
The virus is widespread in West Africa, particularly in Benin, Guinea, Liberia, Sierra Leone and Nigeria.
Symptoms/transmission
Lassa fever can be deadly if not cured during its early stage. Typical symptoms of this disease include high fever, general weakness, sore throat, cough, nausea, vomiting, and diarrhea.
Later symptoms include bleeding, rashes and swelling of the eyes and genitals. The incubation period lasts from six to 21 days, according to the World Health Organisation (WHO).
Contamination can be prevented by, among other things, storing food in containers not accessible to rodents, disposing of garbage far from home and avoiding contact with bodily fluids of sick people.
While most humans are infected either from contact with an infected rat or inhalation of air contaminated with rat excretions, like other hemorrhagic fevers, Lassa fever can be transmitted directly from one human to another.
It can also be contracted through direct contact with infected human blood excretions and secretions, including through sexual contact.
No evidence of airborne transmission person-to-person is seen. But, trans- mission through breast milk has also been observed. However, public health experts have advised that it is very important to practice preventive measures to avoid infection of Lassa fever.
Ensuring frequent hand washing with soap and running water, proper environmental sanitation, and proper covering of foodstuff to avoid contact with rats have been known to be very effective in combating the disease.
It can be difficult to clinically distinguish Lassa fever from other infectious diseases such as malaria, typhoid fever, shigellosis, yellow fever and other viral haemorrhagic fevers, especially early in the course of the disease. Confirmation is necessary.
Treatment
Early intensive supportive care including fluid management and treatment of specific symptoms, can improve survival chances. There is currently no antiviral drug approved for Lassa fever. The antiviral drug ribavirin has been given as treatment for Lassa fever.
However, there are concerns about its efficacy on the outcome of patients as well as on its optimal dosing regimens.
