?Surveillance system needed to tackle reported cases ? Don

?FG should implement more policies to combat menace ? Dr. Oko

? We?ve enhanced surveillance, contact-tracing in affected states ? NCDC

The Nigeria Centre for Disease Control and Prevention (NCDC) recently revealed another outbreak of Lassa fever in 11 states and 63 local government areas across the country, with fatalities hitting 80. PAUL OKAH and HELEN OJI in this report wonder if the federal government is doing enough to combat another epidemic.

Lassa fever, named after the Nigerian town in Borno state where it was first identified in 1969, is among a U.S. list of Category A diseases that are deemed to have the potential for major public health impact, alongside anthrax and botulism. The disease is carried by the Mastomys Natalensis rodent, found across sub-Saharan Africa and often eaten as a source of protein. It is said to infect an estimated 300, 000-500, 000 people each year and kills nearly 5,000.

As a viral haemorrhagic fever caused by the Lassa virus, it is transmitted through contact with infected rodents, their urine or faeces. The first reported cases of Lassa fever occurred in the 1940s in Nigeria. Initially, the disease was misdiagnosed as yellow fever or malaria.

However, Lassa virus was first isolated in 1969 from a missionary nurse, Laura Wine, who died from the disease in Lassa, Borno state. The virus was identified as a new arenavirus which was later named Lassa virus. Lassa fever remains an endemic disease in Nigeria, with ongoing transmission and periodic outbreaks.

The virus is endemic in several West African countries, including Nigeria, Liberia, Sierra Leone, Guinea and Ghana. Cases have also been reported in other parts of Africa as well as in Europe and North America, primarily among travellers returning from endemic areas.

Major outbreaks, NCDC?s statistics

Blueprint Weekend?s investigations revealed that a major outbreak of Lassa fever occurred in Nigeria in 1970, with over 100 reported cases. Between 1989 and 1990, a large outbreak in Nigeria resulted in over 1, 000 reported cases. Again, in 2018, a major outbreak occurred in Nigeria, with over 1, 500 reported cases and a case fatality rate of 20 per cent.

Most recently, the NCDC reported 80 deaths from 413 confirmed Lassa fever cases across 11 states during an Epidemiological Week 6 (February 3?9, 2025), following an outbreak reported in 2024, with over 4,726 cases and many fatalities.

In its latest Lassa Fever Situation Report on its official website, the NCDC reported 80 deaths from 413 confirmed Lassa fever cases across 11 states of Ondo, Taraba, Edo, Benue, Gombe, Kogi and Ebonyi, noting that the case fatality rate (CFR) had risen to 19.4 per cent, up from 17.5 per cent in the same period in 2024.

The Agency also revealed that 73 per cent of confirmed cases came from Ondo, Edo, and Bauchi states, with Ondo leading at 34 per cent, followed by Edo at 21 per cent and Bauchi at 18 per cent, stating that a total of 63 local government areas in the 11 states had recorded confirmed cases.

The NCDC said, while no new health care worker infections were reported in the week, delayed case presentations had contributed to the rising fatality rate, identifying poor health-seeking behaviour, high treatment costs, and limited awareness in high-burden communities as major challenges.

Actions taken

To address the outbreak, the NCDC said it had activated the National Lassa Fever Multi-Sectoral Incident Management System (IMS) to coordinate efforts.

It added that it was also collaborating with the World Health Organisation, M?decins Sans Fronti?res (MSF), also known as Doctors Without Borders, and the International Research Centre of Excellence to improve diagnosis, treatment and outbreak response.

The Agency urged Nigerians to take preventive measures, including maintaining proper hygiene, avoiding contact with rodent droppings, and seeking medical attention early if symptoms like fever, sore throat and unexplained bleeding occur.

The NCDC further urged Nigerians to reduce their risk of infection by storing food properly in sealed containers to prevent rat contamination, stating that Lassa fever is preventable, even as it encouraged Nigerians to stay informed and to take action to protect themselves and their loved ones.

What to do

In an exclusive interview with Blueprint Weekend, an Associate Professor of Infectious Disease and Genomics, Department of Microbiology, Adeleke University, Oladipo Kolawole, said Nigerians need to improve the existing surveillance system to quickly identify and report Lassa fever cases.

He said there should be access to treatment by ensuring adequate supply of ribavirin, which is the primary treatment for lassa fever, adding that this will encourage early treatment to improve survival rates.

According to Prof. Kolawole, the federal government, through the NCDC, has been playing crucial roles in coordinating surveillance, detection and response efforts across the country.

He emphasised that to avoid Lassa fever outbreaks, citizens can take several preventive measures such as avoiding contact with rodents, proper food storage and processing, personal hygiene, avoiding contact with infected individuals, staying informed always and seeking medical attention early.

To reduce the Lassa fever outbreak in states like Edo, Ebonyi, Ondo and Bauchi, Prof. Kolawole several measures can be taken such as strengthening surveillance systems and engaging with local communities to ensure cooperation and participation in prevention efforts.

What govt should do

A UK-based medical doctor, Chevening scholar and founder of Healthy and Smart Children Foundation, Dr. Christian Inya Oko, advised the federal government to invest more funds and implement policies that would help to effectively control Lassa fever. He said he lost many doctor friends to the epidemic, apart from other unsuspecting Nigerians.

He said, ?Having lost three of my doctor-friends, together with more than 800 other Nigerians to Lassa fever, I feel greatly worried about hearing the recent NCDC report. On the 2024 annual report, the National Centre for Disease Control (NCDC) reported about 1300 confirmed cases, 16.3% fatality rate with 214 deaths in 28 states. Ondo, Edo and Bauchi states were at the top of the list, while Taraba, Ebonyi, Enugu and Plateau also gave red marked reports. In the 6th week of 2025, there were already 80 deaths from 413 cases, with 10 more deaths in the present week.

?With these statistics, there is increasing concern about the efficacy of control measures being applied in the control of Lassa fever. Lassa fever is a significant public health concern in Nigeria, where it?s endemic. The disease is primarily transmitted to humans through contact with food or household items contaminated with urine or feces from infected Mastomys rats. Given its dry seasonal occurrences (worse from December to March) and high rate of death, there are questions about how long it would take Nigeria to effectively control this public health threat and save the lives of health workers and the general public.

?Reflecting on our management of the endemic Lassa fever, my mind quickly goes to the recent Covid-19 pandemic, the immediate response of the World Health Organisation and the immediate policy reforms and implementation with backup funds by different countries in the world. One tends to ask if the Nigerian government is taking its control as seriously as they should or if the WHO and other international health organisations are not very interested in helping Nigeria eradicate it. However, with the recent discouragement from seeking foreign aids, Nigeria would have to invest more funds and implement policies that would help to effectively control Lassa fever.

?With the control of the Covid-19 pandemic, there are similar public health measures that could be applied in the control of Lassa fever. Primarily, health education is of great importance in the prevention of Lassa fever. There should be measures placed in the communities, which include storing grain and other food in rodent-proof containers, disposing of garbage away from homes, keeping homes clean, and keeping cats in the home.?

?Risk communication and community engagement activities should be done to raise awareness and promote prevention practices. There should also be extensive education on the early symptoms of Lassa fever to ensure quick presentation to a health facility, assessment, and possible referral to a centre for treatment if diagnosed.

?There should also be training of health workers in primary secondary and tertiary healthcare facilities to ensure detection, treatment, and prevention. Patients who are diagnosed should be freely offered best medical care with all facilities set in place to ensure their recovery.

?An enhanced surveillance system would help to detect cases early and effective data management would ensure that data is quickly captured to inform intervention decisions as soon as possible. Also, more funds should be put into research towards the trial and approval of Lassa fever vaccines. This will greatly grant protection against the seasonal occurrences and deaths.

?Lassa fever has become seasonal in Nigeria, causing hundreds of deaths yearly, including health workers who got infected in caring for infected patients. However, its control can be improved of public health measures are effectively put in place and adequate funds are budgeted and utilised to improve patient care.?

In her contribution, a nurse based in Abakaliki, the Ebonyi state capital, Precious Obinna, said she was traumatised to watch children die of the virus, but glad that the federal government is working to combat the epidemic.

She said, ?Lassa fever has been a significant public health concern in Nigeria for several decades. As a nurse in Abakaliki, it was traumatizing to watch children die in my arms, apart from helpless and ignorant adults. Ebonyi seemed to have its fair share of the outbreak last year as countless number of people died from the virus without even knowing what it was all about. In fact, last year, 394 suspected cases were recorded in Ebonyi, with 48 confirmed cases, 23 deaths and 25 people discharged.

?At a point, I took Lassa fever awareness campaigns to all corners of public and selected private schools in Abakaliki, as well as market spaces within the state, alongside some corps members. We educated them on how to prevent this deadly disease.

?Lassa fever is a viral hemorrhagic fever common in West Africa, particularly in Nigeria, with Ebonyi state being one of the most infected states. It?s spread through contact with infected rodents, their urine, or feces. Last week, it was reported that Lassa fever is back in some states, with fatalities confirmed already.?

Continuing, she said, ?Symptoms to watch out for are fever, headache, sore throat, vomiting, diarrhea and abdominal pain. Please be watchful and take precautions. Keep your environment clean and disinfected; store foods in sealed containers; avoid contact with rodents and their droppings; practice good hygiene.

?It is good to add that research on a vaccine against Lassa fever has been ongoing since the 1980s, with several candidates in various stages of development. Improved surveillance and outbreak response efforts have helped to reduce the impact of Lassa fever outbreaks in recent years. While progress has been made in understanding and controlling Lassa fever, continued research, surveillance and outbreak response efforts are necessary to mitigate the impact of this disease.

?As we?re aware, Nigeria?s health care infrastructure is limited, making it challenging to respond to outbreaks effectively. Nevertheless, improved surveillance and reporting are necessary to detect outbreaks early and respond promptly.?

NCDC?s disclosures, admonition

When our reporter visited the NCDC headquarters for a reaction on the outbreak, a senior official of the Centre, who asked not to be named in print, redirected him to its website, saying he was not authorised to speak, but that the Centre regularly updates the public.

Nevertheless, following the recent outbreak, the NCDC said it remains concerned about the high fatality rate, adding that it has enhanced surveillance and contact-tracing in affected states. It advised Nigerians to keep their homes clean, eliminate rodent hiding places and report cases to its toll free number.

?In spite of a drop in new cases from 68 in Week 5 to 54 in Week 6, the agency remains concerned about the high fatality rate. The affected age group is primarily 21 to 30 years, with a male-to-female ratio of 1:0.8.

?The key interventions include deployment of National Rapid Response Teams (NRRT) to Gombe, Nasarawa and Benue. The interventions also involve training health care workers in Lassa fever case management in Bauchi, Ebonyi and Benue, enhanced surveillance, and contact tracing in affected states.

?Additionally, there will be distribution of response commodities such as personal protective equipment, PPEs, Ribavirin, thermometers, and body bags, along with community sensitization and risk communication campaigns in hotspot areas.

?As the Lassa fever season peaks, the NCDC is intensifying case management training, rapid response coordination and infection- prevention measures to curb the outbreak?s spread. A nationwide rodent control and community awareness campaign is being planned in collaboration with Breakthrough Action Nigeria (BA-N) and other stakeholders. For real-time updates and safety guidelines, the NCDC advises Nigerians to visit www.ncdc.gov.ng or call the toll-free line: 6232.

?Keep homes clean and eliminate rodent hiding places. Practice good hand hygiene by washing hands regularly with soap and water. Avoid bush burning, which drives rats into homes, increasing the risk of infection. Seek medical help early if experiencing fever, weakness, or bleeding, and visit a health facility immediately,? the centre stated on its website. (Blueprint)

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