Healthcare workers at the Federal Medical Centre, Owo, Ondo State, are battling an unprecedented surge in Lassa fever infections as the disease shifts from its traditional seasonal cycle into a continuous, year-round public health crisis.
Medical personnel and nursing officers at the tertiary health institution, which serves as one of Nigeria’s foremost treatment facilities for the viral infection, noted that the disease has defied previous seasonal patterns, creating severe logistical strain and overwhelming frontline personnel.
A Consultant Public Health Physician and Lassa fever case manager at the facility, Dr Ihinmikaye Isaac, explained that the infection has evolved beyond the dry season when rodent movements and human activities typically triggered outbreaks.
Dr Isaac said, “What we knew traditionally about Lassa fever was that it was seasonal. Cases usually increased during the dry season because of environmental factors and human activities. But now, we are seeing cases throughout the year,”.
He noted that the onset of the rainy season, which previously brought a natural decline in viral transmission as rodents retreated, no longer offers respite to healthcare providers.
He stated, “Lassa fever is no longer limited to a particular season. We now see consistent cases all-year-round. There is hardly any opportunity to rest because the cases keep coming.”
Dr Isaac disclosed that Akure South and the Kajola corridor have emerged as major hotspots with a heavy concentration of confirmed cases, adding, “The stress that comes with managing an outbreak, coupled with limited health care workers and a growing number of patients, has been significant,”.
Corroborating the development, an Assistant Director of Nursing Services at the medical centre, Mrs Oyebimpe Oyegunle, stated that the unpredictable transmission curve has complicated patient management.
Mrs Oyegunle said, “Normally, we observe a predictable pattern where the number of patients rise significantly during certain periods and gradually decline afterwards. This time around, the pattern has been irregular. Instead of following the usual trend, the number of patients has fluctuated. Cases increased unexpectedly and remained high. It has been like a zigzag pattern,”.
Medical experts at the centre raised concern that the early symptoms of Lassa fever are frequently misdiagnosed as malaria or typhoid, leading to critical delays in proper clinical intervention.
Dr Isaac explained that patients often present with general weakness, fever, cough, sore throat, vomiting, abdominal pain, and diarrhoea.
Dr Isaac said, “The challenge is that these symptoms are common to several infectious diseases,”.
He advised, “One thing that should raise suspicion is when someone has been treated for malaria but does not improve. Lassa fever should then be considered. As the disease progresses, more severe symptoms may emerge. Patients may begin to pass unusually dark urine, blood in urine, blood in stool, vomit blood or bleed from injection sites. By then, the disease is often advanced,”.
Nurse Oyegunle observed that recent cases have presented unusual clinical signs, adding, “Many patients present abdominal pain. Some female patients have come with breast engorgement, while hearing impairment has become increasingly common among patients.”
Frontline personnel at the isolation wards operate under rigorous infection prevention protocols, wearing heavy layers of personal protective equipment for hours in high temperatures.
Highlighting the risks faced by health workers, Dr Isaac said, “When properly dressed in PPE, every part of the body is covered. Regular hand-washing, decontamination of surfaces and strict infection prevention measures are critical.”
He warned, “Lassa fever does not discriminate. It does not respect doctors or nurses. Once you let your guard down, you become vulnerable.”
Despite the operational hazards, medical personnel remain committed to saving lives. Dr Isaac stated, “What keeps me motivated is passion. Seeing patients recover and return to their families provides a strong sense of fulfillment,”.
Recounting a positive outcome, Mrs Oyegunle said, “We recently discharged a newborn baby who had been critically ill. There were moments when it seemed the child might not survive, but after receiving care, the baby recovered and went home safely. Moments like that keep me motivated,”.
However, the psychological and physical burden remains substantial. Dr Isaac noted, “There are times you become so busy attending to patients that you forget to eat. Sometimes you spend several hours inside the isolation ward. By the time you come out, your body is soaked with sweat because of the protective equipment,” adding that “When you struggle to save a life and still lose that person, it affects you emotionally,”.
Mrs Oyegunle remarked, “Seeing patients you have cared for die despite your best efforts can be very difficult, emotionally and psychologically.”
A survivor receiving care at the centre, Mr Olabode Fatoyinbo, recounted his experience, noting that his illness started with symptoms that resembled a regular fever.
Fatoyinbo said, “I thought it was just the regular thing, so I took some regular malaria medications, but it was not working.”
Following medical referrals and laboratory evaluations, he tested positive for the virus and was admitted to the isolation unit.
He said, “The result came back positive and I was referred to the isolation ward. As soon as I got here, treatment started immediately,” adding, “When people hear Lassa fever, it is very scary. My wife, my brother and family members were all worried because I was very weak and couldn’t even speak,”.
Fatoyinbo commended the management and medical staff of the facility for providing comprehensive care at no financial cost to his family.
He stated, “From feeding to treatment and even laundry, everything has been free. We have not paid a dime since I came here.”
He added, “Before now, hearing about Lassa fever felt like something extremely terrible. But being here, I have seen many people treated and discharged. The biggest misconception is the fear people have about it.”
Advocating intensive public enlightenment to eliminate stigma, Fatoyinbo said, “I think the messages in those advertisements should not only focus on the disease itself. They should also emphasise prompt action and encourage people not to see it as a stigma. People need to know that if they begin to experience symptoms that are unusual or persistent, they should seek medical help immediately. People should not stigmatise anyone who has Lassa fever. That stigma is one reason some people delay seeking treatment and turn to other alternatives”.
He cautioned citizens on environmental hygiene and lifestyle habits, saying, “First, we need to be very careful about how we manage our environment. We should ensure that our food is not exposed and we do not eat in places we do not trust. One of the questions I was asked when I got here was whether I had attended a burial recently, eaten in a public place or had rats in my house. For me, there are no rats in my house, not a single one. I don’t even eat bush-meat. So I can’t really place exactly where I got infected. It could actually be through contact with someone. We need to be very careful and protective of our environment. I also noticed that a lot of people who develop complications are people who take alcohol or smoke. It affects the kidneys and can complicate treatment. I have seen people undergo dialysis several times because of that. Lastly, if you observe that you are not feeling well and the treatment you are taking is not working, don’t just rely on prayers alone or herbal remedies. It is good to pray, but immediately go for proper medical tests to know what is happening.”
Healthcare administrators at the facility identified shortages of critical supplies, particularly Ribavirin, laboratory reagents, and personal protective equipment, as persistent obstacles to effective case management.
Dr Isaac said, “For decades, we have relied largely on one major drug for treatment. Availability remains a challenge because shortages occur.”
He outlined urgent areas requiring intervention, stating, “Improvements are needed in several areas. First, we need a regular supply of laboratory reagents and testing kits. Without them, diagnosis becomes difficult, and delays can increase mortality. Secondly, we need adequate supply of consumables, such as gloves, masks, coveralls, aprons and other PPE used in isolation wards and laboratories. The government should organise regular training and retraining programmes for health care workers and intensify public awareness campaigns. Public education is important because it helps address misconceptions and encourages early presentation. Environmental health officers and other frontline workers should also be protected and supported while carrying out their duties. In addition, frontline health care workers should receive incentives and support. Working in a Lassa fever treatment centre is demanding and hazardous. Many people are reluctant to work in such environments because of the risks involved. Those who serve on the frontline deserve recognition, protection and support.”
Dr Isaac warned that late presentation and delays in diagnosis have previously resulted in fatal infections among health workers.
He said, “Some patients are initially treated for malaria, typhoid or other illnesses before Lassa fever is considered. That delay can be costly. We have lost health workers in the Process.”
He added, “We have recorded health care worker infections and unfortunately lost some colleagues. Many of those cases were linked to delayed diagnosis and late presentation. Some health care workers did not initially suspect Lassa fever, and by the time the diagnosis was made, the disease had already caused severe complications, including kidney failure and bleeding. In recent times, we also recorded health care worker infections among doctors and nurses, but fortunately, those affected received treatment and recovered,”.
Nurse Oyegunle called for sustainable government ownership of Lassa fever response systems, noting, “We have relied heavily on non-governmental organisations for support. While their support has been invaluable, there should be a sustainable framework that allows the government to manage these cases effectively.”
Addressing misinformation and public myths regarding the disease, Oyegunle urged, “Lassa fever is real. People should stop assuming that it is not real or spreading rumours that people are being deliberately infected.”
Dr Isaac maintained that frontline personnel require enhanced safety and welfare packages, reiterating, “Frontline health care workers should receive incentives and support. Working in a Lassa fever treatment centre is demanding and hazardous.”
He concluded, “Seeing patients recover and return to their families is what keeps me going,” while Fatoyinbo stressed that “The earlier the diagnosis, the better. Recovery is possible.”
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