Recurring Outbreaks of Lassa Fever in Nigeria: Understanding the Root Causes and Strategies for the Future
Lassa fever is a severe public health problem in Nigeria with far-reaching political, social, cultural, and religious ramifications. Thus, a further understanding of the disease is critical. Despite attempts to end the viral epidemic, the illness has persisted, leading to several major outbreaks in decades. Additionally, the country’s epidemic in 2019– 2020 set a new global record for the number of Lassa fever cases. This year, 244 cases and 37 deaths had been reported as of January 2023. To identify gaps and provide recommendations for the complete eradication of Lassa fever in the country. This paper investigates the underlying causes of the continuous outbreaks of the illness in Nigeria and the measures to prevent it. The frequent outbreaks of Lassa fever in Nigeria have been linked to several factors, including inadequate waste management, poor sanitation, restricted access to healthcare, and abject poverty. The reoccurring outbreaks are also attributed to a lack of political will, funding, poor coordination and communication, and low public awareness of the illness and its prevention. To effectively stop outbreaks of Lassa fever in Nigeria, the government and partners must continuously put into practice tried-and-true prevention measures such as improved surveillance to detect outbreaks earlier, increased funding and resources to support effective control measures, better primary healthcare facilities and training for healthcare professionals, heightened community engagement and education to raise awareness, and more effective vector control methods to reduce rodent populations, while looking for innovative approaches and dealing with the underlying social and economic problems contributing to the viral persistence.
Lassa fever, hemorrhagic fever, LHF, Nigeria, viral infection
 Aloke, C., Obasi, N. A., Aja, P. M., Emelike, C. U., Egwu, C. O., Jeje, O., Edeogu, C. O., Onisuru, O. O., Orji, O. U., & Achilonu, I. (2023, January). Combating Lassa fever in West African sub-region: Progress, challenges, and future perspectives. Viruses, 15(1), 146.
 Garry, R. F. (2023, February). Lassa fever - the road ahead. Nature Reviews. Microbiology, 21(2), 87–96.
 Opara, N. U., Nwagbara, U. I., & Hlongwana, K. W. (2022, November). The COVID-19 impact on the trends in Yellow Fever and Lassa Fever infections in Nigeria. Infectious Disease Reports, 14(6), 932–941.
 Happi, A. N., Happi, C. T., & Schoepp, R. J. (2019, August). Lassa fever diagnostics: Past, present, and future. Current Opinion in Virology, 37, 132–138.
 Asogun, D. A., Günther, S., Akpede, G. O., Ihekweazu, C., & Zumla, A. (2019, December). Lassa Fever: Epidemiology, clinical features, diagnosis, management and prevention. Infectious Disease Clinics of North America, 33(4), 933–951.
 Grace, J. A., Egoh, I. J., & Udensi, N. (2021, November). Epidemiological trends of Lassa fever in Nigeria from 2015-2021: A review. Therapeutic Advances in Infectious Disease, 8, 20499361211058252.
 Agbonlahor, D. E., Akpede, G. O., Happi, C. T., & Tomori, O. (2021, August). 52 years of Lassa fever outbreaks in Nigeria, 1969-2020: An epidemiologic analysis of the temporal and spatial trends. The American Journal of Tropical Medicine and Hygiene, 105(4), 974–985.
 NCDC. (2023). NCDC Activates Lassa fever emergency operations centre to strengthen the response to rising cases of Lassa Fever in Nigeria. https://ncdc.gov.ng/news/438/ncdc-activates-lassa-fever-emergency-operationscentre- to-strengthen-the-response-to-rising-cases-of-lassa-fever-in-nigeria
 Akpede, G. O., Asogun, D. A., Okogbenin, S. A., & Okokhere, P. O. (2018, September). Lassa fever outbreaks in Nigeria. Expert Review of Anti-Infective Therapy, 16(9), 663– 666.
 Ipadeola, O., Furuse, Y., Ilori, E. A., Dan-Nwafor, C. C., Akabike, K. O., Ahumibe, A., Ukponu, W., Bakare, L., Joseph, G., Saleh, M., Muwanguzi, E. N., Olayinka, A., Namara, G., Naidoo, D., Iniobong, A., Amedu, M., Ugbogulu, N., Makava, F., Adeoye, O., . . . Ihekweazu, C. (2020, May). Epidemiology and case-control study of Lassa fever outbreak in Nigeria from 2018 to 2019. The Journal of Infection, 80(5), 578–606.
 Okoro, O. A., Bamgboye, E., Dan-Nwafor, C., Umeokonkwo, C., Ilori, E., Yashe, R., Balogun, M., Nguku, P., & Ihekweazu, C. (2020). Descriptive epidemiology of Lassa fever in Nigeria, 2012-2017. The Pan African Medical Journal, 37, 15.
 NCDC. (2022). An update of Lassa fever outbreak in Nigeria. https: //ncdc.gov.ng/diseases/sitreps/?cat=5&name=An%20update%20of%20Lassa% 20fever%20outbreak%20in%20Nigeria (Accessed Feb. 09, 2023).
 WHO. (2015). Factors that contributed to undetected spread of the Ebola virus and impeded rapid containment. https://www.who.int/news-room/spotlight/oneyear- into-the-ebola-epidemic/factors-that-contributed-to-undetected-spread-ofthe- ebola-virus-and-impeded-rapid-containment
 Bagcchi, S. (2020, May). Lassa fever outbreak continues across Nigeria. The Lancet. Infectious Diseases, 20(5), 543.