Reported by: Oahimire Omone Precious | Edited by: Henry Owen
Abuja, Nigeria — Public health specialists in Nigeria have highlighted a combination of systemic weaknesses and behavioural challenges as key drivers behind persistent deaths from Lassa fever, even seven years after the Nigeria Centre for Disease Control and Prevention (NCDC) formally recognised the disease as a public health emergency.
According to medical experts who spoke with health correspondents this week, continued high fatality rates are closely tied to late hospital presentation, limited treatment infrastructure, poor environmental sanitation and gaps in disease surveillance. These factors, they argue, have hampered efforts to control outbreaks and reduce mortality, leaving many patients to seek care only after their condition has deteriorated.
Lassa fever, a viral haemorrhagic illness endemic to parts of West Africa, is spread to humans primarily through contact with food or household items contaminated by the excreta of infected rodents, especially the multimammate rat. Human-to-human transmission can also occur, particularly in healthcare settings where infection prevention and control measures are inadequate. While Nigeria has recorded seasonal spikes in cases for decades, the disease’s public health impact remains profound and recurrent.
Public health physicians emphasised that only one effective antiviral treatment — ribavirin — is currently available, and its success is highly time-sensitive. Ribavirin can significantly improve outcomes when administered early in the course of illness, ideally within the first six days of symptom onset. However, many patients in affected states present at healthcare facilities late, often after days of fever, vomiting, weakness and bleeding, reducing the drug’s effectiveness and increasing the likelihood of complications and death.
“Too many people wait until they are critically ill before coming to the hospital,” one clinician involved in Lassa fever response said. “By the time they arrive, the virus has already caused extensive damage, and the window for effective treatment has often closed.” This pattern of delayed presentation reflects broader issues in health-seeking behaviour, including limited awareness of early symptoms, reliance on traditional medicine and barriers to accessing care due to distance, cost or fear of stigma.
Experts also pointed to shortages of dedicated treatment centres as a significant structural challenge. While some states have established isolation units or Lassa treatment centres, these facilities are sparse relative to the geographic spread of the disease. In many high-burden regions, suspected cases must travel long distances to reach specialised care, compounding delays in treatment and isolation that are essential for reducing transmission and improving survival.
In addition, poor environmental sanitation continues to fuel the persistence of rodent vectors. Ineffective waste management, the presence of refuse near homes and markets, and inadequate housing conditions facilitate human–rodent contact, creating ongoing risks for Lassa fever outbreaks. Public health officials argue that sustainable improvements in sanitation — including community-level refuse collection, rodent control and safer food storage practices — are critical prevention strategies that have yet to be fully realised.
Inadequate surveillance systems were also cited as a barrier to early detection and response. Although the NCDC coordinates nationwide surveillance for Lassa fever and other priority diseases, gaps remain in community reporting, laboratory capacity and rapid case investigation, particularly in rural and hard-to-reach areas. Delays in detecting and confirming outbreaks can slow public health responses and allow the disease to spread unchecked within communities.
Seven years after the emergency declaration, Nigeria continues to record seasonal cases and fatalities, with outbreaks often peaking during the dry season — typically between December and April — when rodent populations and human exposure risks tend to rise. In recent seasons, states such as Edo, Ondo, Bauchi and Plateau have consistently reported significant caseloads, straining local health systems and drawing attention to the need for sustained investment in prevention and care.
Public health leaders are calling for a multi-pronged approach to address the challenge, combining community education on early symptom recognition and the importance of prompt care, expansion of treatment centres and isolation units, strengthened surveillance and laboratory networks, and concerted efforts to improve environmental sanitation. They also urge increased funding for Lassa fever research, including the development of new therapies and vaccines.
“The tools we have now work, but only if we use them early and we use them well,” said one epidemiologist involved in outbreak response. “We must change how communities perceive and respond to fever illnesses, and we must build systems that deliver care where and when it’s needed.”
As Nigeria enters another peak season for Lassa fever, health authorities are renewing calls for vigilance, community participation and government support to reduce the toll of a disease that has persisted as a major public health challenge despite years of concerted efforts.
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