By Osayi Aghahowa News Agency of Nigeria (NAN)
In many Nigerian communities, people often automatically assume any fever is malaria.
Health experts warn this common habit delays the diagnosis and treatment of Lassa fever, making the disease much harder to contain.
For many families struggling with poverty, daily survival often takes precedence over concerns about diseases that may seem distant or unfamiliar.
That reality is reflected in the experience of Mrs Esther Aigbe, a pregnant mother of six, living in Benin City.
While preparing a pot of soup for her family, a rat fell into the food.
Rather than discard the meal, she removed the rodent and continued cooking. For Aigbe, wasting food was not an option.
“I cannot afford to throw the food away; my children have to eat.”
In the midst of this engagement, another rat scurried across the floor of her shared outdoor kitchen.
Her response highlights the difficult choices many low-income households face, where concerns about contamination are often outweighed by the immediate need to provide meals for family members.
Like many Nigerians, Aigbe associates fever primarily with malaria, a disease that remains common across the country and is frequently treated without laboratory confirmation.
“When my children have fever, I just go to the pharmacy and buy malaria drugs. Lassa fever has never crossed my mind.”
Asked whether she worried about contracting Lassa fever, she laughed off the possibility, reflecting a belief that experts say remains widespread in many communities.
“That sickness is for rich people. Rodents are everywhere here. If I dispose of food every time I see a rat, we will starve,” she said.
Health professionals say such attitudes contribute significantly to the spread and severity of Lassa fever because the disease is often not considered until symptoms become severe.
According to medical experts, one of the greatest challenges associated with Lassa fever is that its early symptoms closely resemble those of malaria and typhoid fever.
As a result, many patients delay seeking proper medical attention.
Dr Nosa Ehigie, Medical Director of Owen Hospital, Benin City, said Lassa fever remained one of the most misunderstood infectious diseases in Nigeria in spite of repeated outbreaks and extensive public health campaigns.
“Lassa fever is a type of viral haemorrhagic disease; it is classified as an acute viral haemorrhagic fever.
“While many cases are mild or completely asymptomatic, severe cases can cause vascular instability, multiple organ failure and uncontrolled bleeding.”
Ehigie explained that the illness often began with symptoms such as fever, weakness, headache and general body discomfort, signs that many people commonly associated with malaria.
Because malaria is widespread and familiar, patients frequently begin self-medication or receive treatment for malaria without considering alternative diagnoses, especially during the early stages of illness.
“Patients may initially receive treatment for malaria or typhoid fever, but persistent fever that does not respond to treatment should raise suspicion of Lassa fever, particularly when accompanied by bleeding symptoms.
“The disease may progress to vomiting blood, coughing blood or other forms of bleeding.
“Once such symptoms appear, there should be a high index of suspicion and the case should be reported immediately.”
The physician noted that the virus could spread through contact with infected body fluids, secretions and contaminated materials, increasing the risk of transmission within households and healthcare facilities.
“People handling rodents with bare hands also risk exposure to the virus.”
He urged residents to maintain clean environments, eliminate conditions that encourage rodent infestation and seek medical attention promptly whenever fever persists despite treatment.
“Suspected cases should be isolated and reported to health authorities for testing and proper management.
“Specialised treatment centres exist for confirmed cases and private hospitals are expected to refer such cases appropriately,” he said.
Ehigie identified Irrua Specialist Teaching Hospital in Edo State as one of Nigeria’s leading facilities for the diagnosis and treatment of Lassa fever.
Public health analysts agree that awareness remains one of the weakest links in Nigeria’s response to the disease.
Many residents continue to regard recurring fever as malaria and seldom consider other possibilities.
One community health expert observed that Lassa fever often disguised itself during its earliest stages, making public education especially important in affected communities.
“Lassa fever is a disease that essentially disguises itself because some of the initial symptoms are very similar to malaria.
“A lot of people mistake it for malaria and lose valuable time before seeking proper treatment,” the expert said.
Beyond the challenge of diagnosis, environmental and socioeconomic conditions continue to support the spread of the disease in many parts of the country.
Rodent infestation remains common in densely populated communities where poor housing conditions, inadequate sanitation and limited waste management services create favourable conditions for disease transmission.
Many households still struggle with poor refuse disposal systems, overcrowded living conditions and inadequate food storage facilities, all of which increase exposure to rodents.
Health stakeholders argue that reducing transmission will require sustained investment in sanitation, environmental management and public awareness programmes, especially in vulnerable communities.
Meanwhile, the Nigeria Centre for Disease Control and Prevention (NCDC) has intensified surveillance, awareness and response activities in states affected by the disease.
The agency said it trained 62 infection prevention and control focal persons across Lassa fever ring facilities in Ebonyi and Ondo states with support from the World Health Organisation (WHO).
Incident Management Systems have also been activated in Oyo, Benue, Plateau, Kebbi, Kano and Gombe States to strengthen outbreak coordination and emergency response mechanisms.
In Edo and Ondo states, risk communication and community sensitisation campaigns have involved traditional rulers, religious leaders, farmers, traders and market women.
The NCDC also developed a 30-day healthcare worker protection plan with support from WHO and the United States Centres for Disease Control and Prevention (US CDC).
The initiative is designed to reduce infections among frontline health workers, who often face increased risks while managing suspected and confirmed cases.
Additional interventions include contact tracing, deployment of rapid response teams, laboratory testing, integrated case management training and the distribution of personal protective equipment.
According to the agency, treatment of confirmed cases is ongoing at designated centres across the country, with authorities continuing efforts to improve preparedness and response capacity.
The persistence of Lassa fever, as revealed by epidemiological trends, highlights that all hands must be on deck to urgently intensify public awareness and preventive education to successfully reduce disease transmission.(NANFeatures)
Edited by Chijioke Okoronkwo
