Head of disease prevention and control at the Nigeria Centre for Disease Control and Prevention (NCDC), Dr. Tochi Okwor has recounted the devastating impact of the 2018 Lassa fever outbreak, which exposed significant gaps in infection prevention and control (IPC) within Nigeria’s healthcare system.
Okwor shared her experience in an interview with journalists on Monday in Abuja, reflecting on how the outbreak overwhelmed hospitals and put healthcare workers at risk. Despite lessons learned from previous health crises, particularly the Ebola outbreak, the Lassa fever epidemic demonstrated that IPC measures were still not fully integrated into everyday hospital practices.
According to Science Nigeria, the NCDC reported a decline in new Lassa fever cases in Epidemiological Week 9, 2025, with 29 new cases recorded across nine states, down from 54 cases the previous week. However, the fatality rate remains high at 18.7 per cent, with 100 deaths reported so far this year. The hardest-hit states – Ondo, Bauchi and Edo – account for 72 per cent of all confirmed cases, with Ondo leading at 31 per cent. Additionally, one new healthcare worker has been infected, bringing the total number of affected health workers in 2025 to 17.
During the 2018 outbreak, healthcare facilities that were meant to serve as safe havens became hotspots for disease transmission. Okwor recalled that overcrowded emergency departments and makeshift holding areas for suspected Lassa fever patients created dangerous conditions, even for the most experienced medical personnel. “Every infection was a wake-up call, a reminder of the vulnerabilities in our system,” she said.
The crisis infected 44 healthcare workers, highlighting the urgent need for systemic reforms. Okwor emphasised that these were not just statistics but frontline defenders whose safety had been compromised. The outbreak underscored that IPC advocacy and curriculum development had yet to translate into concrete, everyday practices in hospitals.
In response, she led a nationwide assessment using the WHO Infection Prevention and Control Assessment Framework (IPCAF), extending beyond immediate treatment centres to full hospital evaluations. This data-driven approach exposed systemic weaknesses and laid the groundwork for critical recommendations aimed at integrating IPC into routine healthcare practices, rather than treating it as an emergency measure.
“It wasn’t enough to merely respond to the outbreak,” she stated. “We needed a lasting system to protect our healthcare workers every day.” This realisation led to the creation of the IPC Scorecard, now used in hospital audits and national health facility assessments to ensure consistent implementation of infection control measures.
Okwor stressed that IPC must be embedded in daily hospital operations to protect both patients and medical personnel. Her journey from witnessing the devastating effects of IPC gaps to leading national policy reforms reflects a broader imperative – infection control cannot be an afterthought; it must be the foundation of every healthcare system.
As Nigeria continues to strengthen its IPC framework, the lessons of 2018 remain a powerful reminder of the need for systemic change. Okwor’s determination to create a safer environment for healthcare workers serves as both a call to action and a testament to the resilience of the country’s public health sector. Her story highlights the challenges and triumphs in Nigeria’s fight against infectious diseases, reinforcing the need for bold, data-driven leadership in times of crisis.
Lassa fever, a viral hemorrhagic disease, is caused by the Lassa virus and is primarily spread through contact with food or household items contaminated by urine, faeces, or saliva of infected rodents. Human-to-human transmission also occurs, particularly in healthcare settings with inadequate IPC measures. Nigeria records Lassa fever cases year-round, with peak transmission occurring between October and May.
