It was a Thursday morning. I was just waking up when my phone buzzed. A group chat message is being circulated by my senior and several colleagues:

"All students are to avoid the emergency until further notice. Also, avoid close contact with all persons within the hospital as a suspected case of Lassa fever has been recognized."

I read it twice. Fourth year of medical school, and the disease I had only ever heard about in the news and textbooks was now in close proximity.

For a moment, the fear was real. And that fear was not irrational. Health workers in West Africa have died from Lassa fever. Often, they die not because they didn't know the risks, but because the systems meant to protect them failed.

Why Health Workers Are So Vulnerable

Lassa fever is caused by the Lassa mammarenavirus, which is harbored by the multimammate rat (Mastomys natalensis). The virus can be transmitted to man by coming into contact with rodents' urine or feces. In addition, the virus can be spread directly from one person to another. In a hospital setup, this means that the virus can be transmitted from a patient to a healthcare worker.

The causes are frustratingly obvious:

Lassa fever symptoms are very similar to those of malaria. In West Africa, where Lassa fever is endemic, malaria is extremely common. In fact, malaria is the default diagnosis. By the time Lassa fever is suspected, healthcare workers may have already been exposed to the virus without any precautions. In addition, rapid diagnostic facilities are scarce. Unlike malaria, which has inexpensive and readily available rapid diagnostic tests, Lassa fever can only be diagnosed by PCR. The delay in confirmation means that infection prevention measures are often implemented late or not at all. Also, the protective gear is not always there. While guidelines exist, the reality on the ground can be different. PPE supplies may be inconsistent. In teaching hospitals, where students and trainees are learning, proper use of PPE is not always supervised or enforced. And when you are seeing dozens of patients a day, fatigue erodes vigilance.

These are not theoretical problems. Data from the Nigeria Centre for Disease Control (NCDC) shows that healthcare workers consistently account for a significant proportion of Lassa fever cases during outbreaks. In 2018, one of the largest outbreaks in Nigeria's history, dozens of health workers were infected. Some died.

The tragedy is that most of these are preventable.

A Painful History: Health Workers Who Paid the Ultimate Price

In Nigeria, it's not new that healthcare workers are more likely to get sick with infectious diseases. It is a story written in the names of those we have lost.

Dr. Ameyo Adadevoh was the first person to diagnose Ebola virus disease in Lagos in 2014. The first patient was a Liberian-American diplomat who had come to the city knowing he had been exposed. Dr. Adadevoh and her team at First Consultants Hospital refused to let the patient go, even though they were under political pressure to do so. That brave act probably kept Nigeria from having a much bigger epidemic.

But it came at a cost. Dr. Adadevoh became infected with Ebola and died on August 19, 2014. She was one of several Nigerian health workers who lost their lives in that outbreak. Dr. Adeola Ogunmola, a nurse, also died after caring for Ebola patients. The Ebola outbreak exposed the same gaps we see today: delayed recognition, inadequate PPE, insufficient training, and a health system that asked its workers to serve without fully protecting them. After the outbreak, there were promises of reform. The Nigeria Centre for Disease Control was strengthened. Infection prevention protocols were revised. But the deeper structural issues (unreliable supplies, overworked staff, and a culture that normalizes risk) remained.

Lassa came before Ebola. In earlier outbreaks, Nigerian health workers also died. A doctor in Ebonyi State died in 2012 after caring for Lassa patients without enough protection. A doctor in Abakaliki died in 2016. Every death was a warning. It looks like people only partly listened to each warning.

We are living with the effects of forgetting history today, as we face another Lassa fever season with dozens of healthcare workers already sick. The names of the dead are more than just memorials; they show that the system still hasn't figured out how to protect its own

The 2026 Numbers: A Wake-Up Call We Are Ignoring

As I write this, the NCDC's latest situation report paints a grim picture of what is happening across Nigeria right now.

In Epidemiological Week 9 of 2026 (February 23 to March 1), six healthcare workers were infected with Lassa fever in a single week. Cumulatively, as of that week, 37 healthcare workers had been infected in 2026 alone. Earlier in the year, in Week 7, the NCDC reported 15 confirmed cases and 2 deaths among healthcare workers within one reporting period.

The overall national numbers are sobering. Nigeria has recorded 2,446 suspected cases and 469 confirmed cases of Lassa fever in 2026, with 109 deaths so far. The case fatality rate stands at 23.2 percent, significantly higher than the 18.7 percent recorded during the same period in 2025.

Geographically, the disease is concentrated: 86 percent of all confirmed cases have been reported from just five states: Bauchi (28%), Ondo (22%), Taraba (19%), Benue (9%), and Edo (8%). Eighteen states and 69 local government areas have recorded at least one confirmed case this year.

The NCDC has identified several persistent challenges: late presentation of cases at health facilities, poor health-seeking behavior due to the high cost of treatment, and inadequate awareness in high-burden communities. But the agency is also very worried about one specific trend: the rising number of infections among healthcare workers.

In March 2026, the NCDC and the Nigerian Medical Association put out a joint advisory telling doctors and other health care workers to be more careful. The advisory had a shocking admission: "A significant proportion of infected healthcare workers this season are doctors and nurses, highlighting the risks faced by frontline medical personnel who are often the first point of contact for patients presenting with undiagnosed febrile illnesses".

The Policy Gap: What Exists on Paper vs. What Happens in Practice

Nigeria has a National Guideline for Lassa Fever Case Management. The NCDC has published infection prevention and control (IPC) protocols. There are training modules on viral hemorrhagic fevers.

On paper, the protection exists, but policy is not practice, and the gap between them is where health workers fall through. Furthermore, there is a cultural dynamic involved, as many health care workers feel that risk is part of the job in that "Medicine is a calling." This view of medicine can be considered honorable; it can also be dangerous when risk is considered a substitute for actual protection, allowing administrative staff to postpone implementing safety measures and causing health care workers who report breaches of protocol to feel as though they are being disloyal rather than protecting themselves. The NCDC has recognized the existence of these gaps. In an advisory issued in January 2021, NCDC stated that "protecting healthcare workers and preventing healthcare-associated transmission of infections is a national priority;" and has directed that there should be complete adherence to infection prevention and control measures including washing hands regularly, using personal protective equipment (PPE) properly, disposing of sharps safely and cleaning clinical environments effectively; the agency has also advised that healthcare facility administrators should ensure that there is a continuous supply of materials for infection prevention and control purposes.

But as the numbers show, these calls are not yet translating into consistent protection on the ground.

What This Experience Left in Me

The first thing I felt when I got up that morning was an overwhelming sense of awareness that I was going to be joining a different kind of healthcare system. The thing I felt in addition to that was an uneasy feeling at the thought of working in this new healthcare system, and the fear that one day, I too, could become infected with the virus.

I also thought about the patients. The first case at our hospital was a person who had come for care, not knowing they were carrying a dangerous virus. They deserved treatment without stigma. But the health workers who treated them also deserved to go home safely at the end of the day. The existence of both the patient's and the health care worker's safety is not mutually exclusive; they are two requirements of a functioning health system.

I wondered about the health care workers who lost their lives during the last epidemic. Dr. Adadevoh, the 2014 nurses, and the doctors in Ebonyi and Abakaliki. None of them was careless or did not take precautions; they were simply not protected by their health care system. If we do not make the necessary improvements to the current system, their deaths will only be viewed as "sacrifices" and not the basis for something that will help improve future care.

Conclusion: Protecting Those Who Protect

Lassa fever is an endemic disease in West African regions with tens of thousands of cases annually. Health care workers are always at the forefront of responding to any disease outbreak. We need to implement solid policies that actually work and aren't just words in a manual. Health workers are not disposable. They are the foundation of any response to infectious diseases. When we fail to protect them, we compromise the safety of every patient who walks through the hospital doors.

That Thursday morning, I received a warning. Now, I am writing one: the systems we have are not enough. And the people who stand between a virus and a community should never be the ones we forget to protect.

To all healthcare workers, students, and those in clinical settings, please share this article. There should be discussions about protecting our workforce from future infectious disease outbreaks before an outbreak occurs.

Sources:

· Nigeria Centre for Disease Control (NCDC) Lassa Fever Situation Reports, Epidemiological Weeks 7 & 9, 2026

· NCDC-NMA Joint Advisory on Lassa Fever, March 2026

· 2014 Ebola outbreak in Nigeria; NCDC archives on previous Lassa outbreaks.