Nigeria’s ongoing Lassa fever outbreak is showing a worrying rise in deaths, with new figures from treatment centres and national surveillance pointing not just to wider transmission, but a deepening fatality burden across several states.

Latest figures from the Nigeria Centre for Disease Control and Prevention (NCDC) show that the country has recorded over 500 confirmed cases and 146 deaths from Lassa fever between January and mid-March.

The NCDC also reports that at least 38 healthcare workers have been infected in the current outbreak, with at least three deaths recorded — a pattern experts said reflects both occupational exposure and weaknesses in infection prevention systems.

The report shows that the case fatality rate (CFR) stands at 25.1 per cent, significantly higher than the 18.7 per cent recorded during the same period in 2025, indicating that a greater proportion of infected patients are dying despite ongoing response efforts.

During the reporting week, confirmed cases rose sharply from 40 in week 10 to 66, with new infections recorded in Bauchi, Ondo, Taraba, Plateau, Edo, Benue, Kogi, Gombe and Niger states — suggesting sustained transmission across multiple regions rather than isolated outbreaks.

Cumulatively, 21 states and 82 local government areas have recorded at least one confirmed case in 2026, highlighting the geographic spread of the disease and the challenge of containing it within traditional endemic zones.

Public health experts said the fatality rate is unusually high for a disease that is treatable when detected early, raising concerns about systemic gaps in diagnosis, referral systems and access to care.

Bauchi, Taraba outbreaks drive national fatality trend

The national figures are being driven in part by severe outbreaks in Bauchi and Taraba, where outcomes diverge sharply but point to the same systemic weaknesses.

In Bauchi, data from Médecins Sans Frontières indicate that 311 confirmed cases and 68 deaths were recorded between October 1, 2025 and March 23, 2026, translating to a case fatality rate of about 21.9 per cent — slightly below the national average but still high for a disease with established treatment protocols.

MSF, which has supported Lassa fever treatment in the state since 2022, said it is expanding its efforts in early diagnosis, treatment, and community outreach, including operations in Bauchi, Kirfi, Toro, and Tafawa Balewa local government areas.

Emergency Programme Manager, Dr Ayokunnu Raji, noted that the similarity between Lassa fever and malaria continues to delay diagnosis, as many patients initially receive treatment for more common febrile illnesses.

An MSF official, Abdulkareem Yakubu, added that misinformation and delayed health-seeking behaviour remain key challenges.

“We are not just treating patients; we are also addressing misinformation and strengthening the capacity of local health workers,” he said, stressing the importance of early presentation.

In Taraba State, the outbreak appears even more severe. At the Federal Medical Centre (FMC) in Jalingo, 50 deaths were recorded among 95 confirmed cases, resulting in a case fatality rate of over 52 per cent — more than double the national average and one of the highest facility-level fatality rates recorded in recent outbreaks.

Dr Suleiman Abubakar Kirim, Head of Clinical Services at the hospital, described the situation as the most severe the facility has encountered in recent years.

“This is the most severe Lassa fever outbreak we have seen in recent times,” he said.

He attributed the high mortality largely to late presentation.

“Many patients come to the hospital when the disease is already advanced. At that stage, even with treatment, outcomes are often poor,” he added.

Out of 226 suspected cases managed at the facility, 20 patients have been successfully treated and discharged, while new infections continue to be reported.

Health officials note that severe cases often present with complications such as bleeding, respiratory distress and organ failure, which significantly increase the risk of death, especially where intensive care support is limited — a factor that may partly explain the stark difference between Taraba’s fatality rate and the national average.

Beyond Bauchi and Taraba, endemic states such as Plateau, Edo, Benue, Kogi, Gombe, Ondo and Niger continue to record significant numbers of cases annually, although recent trends suggest a growing burden in parts of northern Nigeria.

Epidemiological patterns indicate that a handful of states account for a disproportionate share of infections, with Ondo, Edo and Bauchi consistently ranking among the highest contributors, underscoring persistent transmission hotspots.

Health system gaps worsening outcomes

In separate chats with Daily Trust, public health experts said the rising fatality rate reflects deeper structural challenges in Nigeria’s health system.

A senior doctor at Kubwa General Hospital in Abuja, who asked not to be named, said the current data points to a persistent gap in early detection.

What we are seeing is not just an increase in cases, but an increase in late-stage presentations. Lassa fever is highly treatable if identified early, but once complications set in, the risk of death rises significantly,” he said.

He noted that many primary healthcare centres lack the capacity to suspect or confirm Lassa fever in its early stages.

“Frontline facilities are still not adequately equipped to differentiate Lassa fever from malaria or typhoid. This is where the problem begins,” he added.

Dr Hammed Alausa, another physician, said weak referral systems are compounding the problem.

“Patients often move from one facility to another before they are correctly diagnosed. By the time they reach a treatment centre, valuable time has been lost,” Alausa said.

He also pointed to the uneven distribution of treatment centres across the country.

“Access is a major issue. In many cases, patients have to travel long distances while critically ill. That delay can be fatal,” he noted.

Health system limitations are further complicated by infection prevention challenges within hospitals.

Management of FMC Jalingo highlighted the importance of structured consumables in reducing transmission risks.

“The absence of properly structured and sterile consumables increases the risk of transmission to healthcare workers and other patients,” the hospital said.

According to Alausa, such risks are not unique to Taraba.

“Infection prevention and control remain inconsistent across facilities. Protecting health workers is critical because once they are exposed, it further weakens the response system,” he said.

The infection of at least 38 healthcare workers further reflects these gaps, with exposures often linked to delayed case recognition, inadequate protective equipment and high-risk emergency interventions.

Community risks, shifting patterns and response gaps

At the community level, transmission continues to be driven by environmental and behavioural factors, particularly during the dry season when rodents, major carriers of the virus, enter homes in search of food.

Another physician, Dr Chukwudi Ifeanyi, said awareness remains a major gap.

“A lot of people still do not understand how Lassa fever is transmitted. Simple preventive measures like proper food storage and waste management are not widely practised,” he said.

He added that misinformation often leads to delayed care.

“Some patients resort to self-medication or traditional remedies before seeking hospital care, and that delay can be deadly,” he said.

Experts also point to a possible geographic shift in Lassa fever transmission patterns.

While southern states such as Ondo and Edo have long been recognised as epicentres, the increasing burden in northern states such as Bauchi and Taraba suggests changing dynamics.

Dr Ifeanyi said this may be linked to environmental and demographic factors.

“We may be seeing the effects of climate variability, population movement, and better detection in previously underreported areas. But regardless of the cause, the response system must adapt quickly,” he said.

To reduce fatalities, experts called for urgent improvements across multiple levels of the health system.

Key recommendations include expanding rapid diagnostic capacity at primary healthcare centres, strengthening referral systems, and decentralising treatment facilities to underserved regions.

Dr Alausa stressed the need for investment in early detection.

“If we can diagnose cases earlier at the community level, we will significantly reduce mortality. That is where the biggest impact lies,” he said.

While emphasising the importance of community engagement, he said: “Prevention starts at the household level. People need to understand the risks and take practical steps to protect themselves.”

In addition, he highlighted the need to strengthen surveillance systems and improve real-time data reporting to enable faster response to outbreaks.

While the expected onset of the rainy season may reduce transmission temporarily, experts warn that seasonal changes alone are not a solution.

A resident doctor, Godwin Ekweke, cautioned that without structural improvements, the country will continue to face recurring outbreaks with high fatality rates.

“We cannot rely on seasonal decline alone. Without strengthening our systems, we will continue to face the same challenge year after year,” he said.

With 146 deaths recorded nationwide within the reporting period, alongside 68 in Bauchi and 50 in Taraba, the latest figures highlight not just the scale of the outbreak but the uneven survival outcomes across states.

For many experts, the message is clear: reducing deaths from Lassa fever will depend less on seasonal patterns and more on how quickly Nigeria can close the gap between detection and treatment.

Until then, the data suggests that the country’s battle against the disease remains far from over. (Daily Trust)

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