Lassa fever is an acute viral haemorrhagic illness that remains a major public health concern in Nigeria. The disease is endemic in several parts of West Africa, with seasonal peaks typically occurring during the dry season, spanning from November to May. In Nigerian clinical practice, healthcare workers encounter this infection frequently in both rural primary health centres and large tertiary facilities. High-density residential areas, improper food storage practices, and poor environmental hygiene significantly drive up annual infection rates across various states.
The causative agent is the Lassa virus, a member of the Arenaviridae family. The primary natural reservoir and vector is the multimammate rat, scientifically known as Mastomys natalensis.
Humans primarily contract Lassa fever through contact with food or household items contaminated with the urine or faeces of infected rats. Eating poorly stored garri or grains left uncovered overnight represents a classic local transmission route.
Person-to-person transmission also occurs, particularly in hospital settings or households when caring for a sick relative. Contact with infectious blood, urine, semen, or other body fluids without proper barrier protection puts nurses and family caregivers at extreme risk.
Once inside the body, the Lassa virus targets endothelial cells, leading to increased vascular permeability, generalized edema, and multi-organ dysfunction in severe cases. The incubation period ranges from six to twenty-one days.
Early identification saves lives, but Lassa fever mimics malaria and typhoid fever in its early stages. A thorough nursing assessment must include a detailed travel and residential history, asking about contact with rodents or known sick persons.
Laboratory confirmation relies on Reverse Transcription-Polymerase Chain Reaction (RT-PCR) assays, enzyme-linked immunosorbent assay (ELISA) serology, and virus isolation. Routine baseline investigations often reveal proteinuria, elevated liver enzymes, and leukopenia.
Ribavirin is the specific antiviral drug of choice for treating Lassa fever. It works best when administered within the first six days of symptom onset. Supportive therapy remains vital alongside antivirals.
| Clinical Parameter | Management Focus |
|---|---|
| Fluid Balance | IV rehydration guided by electrolyte monitoring |
| Hemodynamics | Vasopressors for shock management |
| Associated Infections | Broad-spectrum antibiotics for secondary bacterial infections |
| Pain and Fever | Paracetamol (avoid NSAIDs due to bleeding risks) |
Caring for a patient with Lassa fever requires strict adherence to barrier nursing protocols inside an isolation ward. The nurse monitors vital signs every four hours, records input and output meticulously to catch renal failure early, and provides psychological support to the frightened patient and family.
Nutritional support is introduced as soon as gastrointestinal symptoms subside. Safe disposal of infectious waste and proper handling of bed linens prevent nosocomial spread to other ward occupants and staff.
Primary health clinics are often the first point of contact for rural patients. Standard, contact, and droplet precautions must be maintained for every suspected case. Hand hygiene using soap and running water or alcohol-based hand rub is non-negotiable before and after patient contact.
Personal Protective Equipment including gowns, gloves, masks, and eye protection must be worn correctly during procedures that generate splashes. Safe burial practices managed by trained infection control teams are mandatory for deceased patients.
Community engagement remains the most effective tool for long-term Lassa fever control. Community health nurses lead campaigns on proper food preservation, covering food items securely in rat-proof containers, and discouraging the hunting and consumption of rodents.
Active surveillance involves tracking suspected cases, reporting outbreaks rapidly to public health authorities, and educating local leaders on early referral of febrile patients to designated treatment centres rather than relying solely on local herbs.