Authors: Kayode Ibrahim Awofe 

This case study examines how the Nigeria Centre for Disease Control (NCDC) tackled an outbreak of Lassa fever and moved from this response to institute a long-term plan to prevent and respond to future outbreaks. 

In late 2015, an outbreak of Lassa fever—an acute hemorrhagic fever caused by a virus usually transmitted by rodents—threatened thousands of lives across Nigeria. By the end of December, the outbreak had spread to 14 states and the Federal Capital Territory, infecting more than 400 Nigerians and killing more than 40. The prevalence of cases forced the government to act quickly to diagnose and treat people before the outbreak became an epidemic. Learning from its experience containing the Ebola virus in 2014, the Nigerian government set up a response team, distributed essential supplies, monitored the outbreak, launched a public awareness campaign, and built public health capacity.

To achieve results, the NCDC had to confront a number of delivery challenges. These included a deficit of organizational capacity and skills, which required quick increases in staff capacity to respond effectively. Testing and laboratory capacity was also expanded. Moreover, some communities were reluctant to use Ribavirin, the drug used to treat Lassa, for reasons related to local religious beliefs and to the spread of misinformation about the disease itself. The NCDC instituted a number of measures, ranging from using social media and WhatsApp to communicate more widely and quickly with the general public,to partnering with local universities to raise awareness among students and health practitioners. 

By August 2017, the government had contained the outbreak and had begun rolling out a long-term plan to prevent future outbreaks. These efforts included knowledge-sharing and awareness-raising activities among health practitioners and farmers (a critical segment of society for controlling Lassa because the disease mostly spread through food contaminated by rodents). It also included improving data practices for Lassa across the country. And the increase in capacity through improved human resources, new hospitals, and a better-equipped diagnostic laboratory meant the NCDC ended this period better prepared to detect and respond to future outbreaks. 

In 2020, Nigeria experienced its largest documented outbreak of Lassa fever, which coincided with the global COVID-19 pandemic. This suggested that further efforts were necessary to enhance preparedness, and in mid-2020 the NCDC was stepping up these efforts.