Beyond the Epidemic: Effective Public Health Strategies in Response to Nigeria's First Lassa Fever Outbreak in a Non-Endemic Region. (Preprint)

Bayelsa State, located in Nigeria's Niger Delta region, had never reported a Lassa fever (LF) outbreak despite the country's 54-year history of such occurrences. This study examines the public health response components to the first-ever LF outbreak in Bayelsa State.

To describe the public health strategies and challenges encountered during the management of Bayelsa State's first Lassa fever outbreak

This descriptive observational study was conducted from February 8th to April 20th, 2023, employing both quantitative and qualitative methods. Sociodemographic, clinical, and public health data were collected from suspected and confirmed LF cases, including their contacts. Additionally, the study reviewed and documented the public health response plans, activities, and experiences during the outbreak

A total of 37 suspected cases were reported, with two confirmed positive via PCR. The index case was laboratory-confirmed approximately nine weeks after symptom onset and tragically passed away five days after her third hospital admission, just a day after diagnosis. The second case, a contact of the index, fully recovered following a mild illness. Among 95 identified contacts, 70 were categorized as high-risk, and 15 exhibited symptoms. All 20 contacts who were tested returned negative results. The outbreak was managed using a multidisciplinary One Health approach aligned with Nigeria’s LF emergency preparedness and response framework. One death was recorded, and 21 contacts were tested. Challenges included low suspicion among healthcare workers, inadequate infection control practices, insufficient personal protective equipment (PPE), shortages of medical commodities, and lack of funding.

All communities within LF-endemic countries, regardless of prior outbreak status, must bolster their preparedness. Emphasis should be placed on preemptive sensitization and training of healthcare workers and investing in the sustainable availability of LF epidemic response commodities. Enhance preemptive healthcare worker sensitization and training in LF non-endemic regions, ensure sustainable availability of PPEs and other LF response commodities as well as strengthen infection control practices and outbreak response funding. This study highlights the importance of preparedness and rapid response, even in regions previously unaffected by LF outbreaks, to minimize the impact of emerging infectious diseases.