What constitutes a fever in adults and children. How to recognize when a fever requires medical attention. What are the appropriate steps to take when dealing with high body temperature. How does fever affect different age groups differently. What are the potential complications of untreated high fever.

Defining Fever: When Body Temperature Rises Above Normal

A fever is generally defined as a body temperature of 100.4°F (38°C) or higher. It’s important to understand that fever itself is not an illness, but rather a symptom of an underlying condition. Fever occurs when the body’s immune system becomes activated, often in response to an infection or other health issues.

But what exactly happens in the body during a fever? When the immune system detects a threat, it releases chemicals called pyrogens. These pyrogens travel to the hypothalamus, the part of the brain that regulates body temperature. The hypothalamus then raises the body’s temperature set point, causing symptoms we associate with fever such as feeling cold, shivering, and seeking warmth.

The Purpose of Fever

While fever can be uncomfortable, it serves an important purpose in the body’s defense mechanism. Higher body temperatures can:

• Slow down the reproduction of bacteria and viruses
• Enhance the activity of white blood cells
• Stimulate the production of disease-fighting substances like interferon

Understanding the purpose of fever can help alleviate some of the anxiety associated with elevated body temperatures. However, it’s crucial to know when a fever becomes too high and requires medical attention.

101°F Fever: A Closer Look at This Threshold

A temperature of 101°F (38.3°C) is often considered a moderate fever in adults. For most healthy adults, a fever of this level is not immediately concerning and can often be managed at home. However, the context in which this temperature occurs is crucial.

What factors should you consider when dealing with a 101°F fever?

• Duration of the fever
• Accompanying symptoms
• Age and overall health of the individual
• Recent exposures or travel history

For instance, a 101°F fever that persists for several days or is accompanied by severe symptoms may warrant medical attention, even in otherwise healthy adults. Conversely, a brief spike to 101°F without other concerning symptoms might not require immediate medical intervention.

Age-Specific Fever Guidelines: When to Worry

The approach to fever varies significantly depending on the age of the individual. Let’s break down the guidelines for different age groups:

Infants (0-3 months)

For newborns and young infants, any fever is considered serious. If an infant under 3 months has a rectal temperature of 100.4°F (38°C) or higher, immediate medical attention is necessary. This is because newborns have immature immune systems and are more susceptible to serious infections.

Older Infants and Toddlers (3 months to 3 years)

For this age group, fever alone is less concerning. However, parents should watch for:

• Temperatures above 102°F (38.9°C)
• Fever lasting more than 24 hours
• Signs of dehydration
• Unusual irritability or lethargy

Children (3 years and older)

In older children, the focus shifts more to the child’s behavior and other symptoms rather than the exact temperature. Seek medical attention if:

• The fever is above 103°F (39.4°C)
• The fever lasts more than 3 days
• The child appears very ill or shows signs of dehydration

Adults

For adults, a temperature of 103°F (39.4°C) or higher is generally cause for concern. Additionally, adults should seek medical care if:

• The fever persists for more than 3 days
• There are signs of dehydration
• There are other concerning symptoms such as severe headache, stiff neck, or rash

Recognizing Serious Symptoms Accompanying Fever

While the temperature itself is important, it’s equally crucial to pay attention to other symptoms that may accompany a fever. These symptoms can often indicate whether the underlying cause is serious and requires immediate medical attention.

Red Flag Symptoms in Children

Parents should be particularly vigilant for the following symptoms in children with fever:

• Difficulty breathing or rapid breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child doesn’t want to be held
• Seizures
• Persistent vomiting

Concerning Symptoms in Adults

Adults with fever should seek immediate medical care if they experience:

• Severe headache
• Unusual skin rash, especially if it rapidly worsens
• Unusual sensitivity to bright light
• Stiff neck and pain when you bend your head forward
• Mental confusion
• Persistent vomiting
• Difficulty breathing or chest pain

Managing Fever at Home: Effective Strategies

For most fevers that don’t reach dangerous levels, home management can be effective. Here are some strategies to help manage fever and its symptoms:

1. Stay Hydrated

Fever can lead to increased fluid loss through sweating. Drinking plenty of fluids helps prevent dehydration and may help bring down the fever. Water, clear broths, and electrolyte solutions are good options.

2. Rest

The body needs extra energy to fight off infections. Resting allows the body to direct more resources towards the immune response.

3. Keep Cool

While you shouldn’t try to rapidly lower body temperature, you can promote comfort by:

• Wearing light clothing
• Keeping room temperature comfortable (around 70-72°F or 21-22°C)
• Using a light blanket if chills occur

4. Over-the-Counter Medications

Fever-reducing medications like acetaminophen or ibuprofen can help lower fever and relieve discomfort. Always follow dosage instructions carefully, especially for children.

When to Seek Medical Care for Fever

While many fevers can be managed at home, certain situations warrant professional medical attention. Let’s explore the specific circumstances that should prompt a call to your healthcare provider or a visit to the emergency room.

Emergency Situations

Seek immediate medical care if:

• An infant under 3 months has any fever
• A child of any age has a temperature above 104°F (40°C)
• An adult has a temperature above 105°F (40.6°C)
• The fever is accompanied by severe symptoms like difficulty breathing, chest pain, or severe abdominal pain
• There are signs of dehydration such as dry mouth, sunken eyes, or decreased urination
• The person experiences a seizure

Non-Emergency Situations Requiring Medical Attention

Contact your healthcare provider if:

• A fever lasts more than three days
• A fever keeps returning
• The fever is accompanied by a new or worsening rash
• You have an underlying medical condition that may be affected by fever
• You’ve recently traveled to an area with known infectious disease outbreaks

Understanding Fever in Special Populations

Certain groups of people may need to approach fever differently due to their unique health situations. Let’s examine how fever affects and should be managed in these special populations.

Immunocompromised Individuals

People with weakened immune systems, such as those undergoing chemotherapy or living with HIV, may not be able to mount a normal fever response. For these individuals, even a slight elevation in temperature could signal a serious infection. If you’re immunocompromised and your temperature reaches 101°F (38.3°C) or higher, it’s crucial to contact your healthcare provider immediately.

Elderly Adults

Older adults may not develop fever as readily as younger individuals, even when they have infections. This is due to age-related changes in the body’s thermoregulatory system. For adults over 65, a temperature of 101°F (38.3°C) or any elevation accompanied by confusion, weakness, or other concerning symptoms should prompt medical evaluation.

Pregnant Women

Fever during pregnancy can potentially affect fetal development, especially in the first trimester. Pregnant women with a temperature of 101°F (38.3°C) or higher should contact their obstetrician or midwife for guidance.

Potential Complications of High Fever

While fever itself is generally not harmful, extremely high or prolonged fevers can lead to complications. Understanding these potential issues can help emphasize the importance of proper fever management.

Dehydration

One of the most common complications of fever is dehydration. As body temperature rises, fluid loss increases through sweating and increased metabolism. Severe dehydration can lead to:

• Electrolyte imbalances
• Kidney problems
• Decreased blood volume
• In extreme cases, shock

Febrile Seizures

Some children between the ages of 6 months and 5 years may experience febrile seizures when they have a fever. While frightening for parents, these seizures are generally short-lived and don’t cause lasting harm. However, any seizure should be evaluated by a medical professional.

Hallucinations

Very high fevers, particularly those above 104°F (40°C), can sometimes cause temporary hallucinations or confusion. This is more common in children but can occur in adults as well.

Heat Stroke

In rare cases, extremely high fevers (above 106°F or 41.1°C) can lead to heat stroke, a potentially life-threatening condition where the body’s temperature-regulating mechanisms fail. This is a medical emergency requiring immediate treatment.

Understanding these potential complications underscores the importance of monitoring fever closely and seeking medical attention when appropriate. While most fevers resolve without incident, being aware of the risks can help ensure prompt action when needed.

When to Seek Care for a Fever

A fever (defined as a temperature of 100.4°F or higher) happens when your body is trying to fight off an infection or your immune system becomes activated. The increase in your body temperature signals that something is not quite right with you.

Sometimes a fever comes and goes quickly, other times it lingers, and your temperature fluctuates over time.

Below is a breakdown of when you should contact your doctor or health care provider if you have a fever:

Adults

Numbers that are cause for concern:

• 105°F – Go to the emergency room
• 103°F or higher – Contact your health care provider
• 101°F or higher – If you’re immunocompromised or over 65 years of age, and are concerned that you’ve been exposed to COVID-19, contact your health care provider

Situations that are cause for concern:

• if you have a fever and it doesn’t go down after taking over-the-counter medications, like ibuprofen
• if you’ve been in hot temperatures and develop a fever, it could be a sign of a heat stroke
• if you’ve been in contact with someone who tested positive for COVID-19, you could be at risk for the virus

Call your doctor for medical advice if you experience any of these situations.

Children

Call your child’s pediatrician under the following circumstances:

• 0-3 months – Your child has a temperature of 100.4°F or higher, with or without symptoms
• 3-6 months – Your child has a temperature of 100.4°F or higher, plus irritable behavior/sleepiness OR a temperature of 102°F or higher
• 6-24-months – Your child has a temperature of 102°F for longer than a day AND symptoms such as a rash, cough or diarrhea
• 2+ years – Your child has a temperature of 100.4°F or higher AND symptoms such as a rash, fatigue, headache, stiff neck, prolonged diarrhea or vomiting

Any age:

• Your child has a seizure
• Your child has a temperature of 103°F or higher
• Any fever that starts after your child has been in hot temperatures (could be a sign of heat stroke)
• Your child’s fever doesn’t go down after taking over-the-counter medications, like ibuprofen
• Your child has been in contact with someone who has COVID-19

Next Steps & Resources: 

• To make an appointment with a doctor near you, call 800-822-8905 or visit our physician directory to make an appointment online.
• Register for telemedicine through HMH Care NOW.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care

Fever 101 – A guide to kid’s fevers

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Posted: May 09, 2022

Fever in children can be a scary thing for parents, often causing them to wonder if a trip to the emergency room is necessary. Le Bonheur Pediatrician Ruth Patton MD, of Pediatric Consultants, shares the advice she often gives parents when their child feels feverish.

“Don’t panic,” says Dr. Patton. “Know that fever is the body’s natural reaction to infection.

Dr. Patton offers three important questions to ask yourself when your child has a high temperature:

1. Is your child’s breathing labored?
2. Is your child drinking less or experiencing decreased urine output?
3. Is your child crying inconsolably?

If you answer yes to any of these questions, it’s best to call your pediatrician’s office, no matter your child’s degree of fever.

Dr. Patton stresses that if you have an infant younger than 2 months with a rectal temperature of 100.4 degrees Fahrenheit or higher, you need to call your pediatrician immediately. Fever in newborns does require an exam, as newborns have immature immunity and are more susceptible to serious illness.

Even if your child does not show signs of serious illness, a fever can make him or her uncomfortable. To make your child as comfortable as possible, you can provide temporary relief by administering a dosage of acetaminophen or ibuprofen if he or she is 6 months or older. Most children with a temperature lower than 101 degrees Fahrenheit may not need medication, but if you notice that your child is uncomfortable, it won’t hurt to give them an over-the-counter medicine. You should also keep your child dressed in light clothing, keep the house at a comfortable temperature, offer plenty of fluids and make sure they rest.

Knowing your child’s normal behavior and the symptoms that are accompanying the fever is the most important information for you to consider. As long as you don’t notice any of the three red flags, a trip to the doctor’s office probably isn’t necessary. Just remember to monitor your child closely. If the fever has not reduced after 24 hours on medication, call your child’s pediatrician.

What temperature is a fever?

100.4 degrees Fahrenheit measured rectally, orally, temporally (forehead) or tympanically (ear).

What ‘is’ a fever?

Fever is the body’s natural defense against infection.

When should I call the doctor?

Call your pediatrician if you have an infant younger than 2 months with a rectal temperature of 100.4F or if your child is experiencing any of the following:

• Labored breathing
• Inconsolable crying
• Decreased drinking or urine output

You should also call your doctor if you have a child with a temperature higher than 104 degrees Fahrenheit or temperature does not respond to medication.

What should I do if my child has a temperature of 104 degrees Fahrenheit but is acting normally?

If your child is not exhibiting any of the behavioral red flags, give your child a dosage of acetaminophen or ibuprofen if he or she is at least 6 months old. Continue to monitor your child’s behavior and call the doctor if the fever has not gone down after 24 hours with medication.

What type of thermometer and method gives the most accurate temperature reading?

A digital thermometer administered rectally will give you the most accurate temperature.

Authored by:

Ruth Patton, MD

Le Bonheur Pediatrician

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Facts you should know about scarlet fever:

• Risk factors for febrile scarlet fever, especially in children aged 5 to 15 years, include overcrowding and sharing dishes, towels, or other items.

• The contagious period of scarlet fever lasts approximately 12 hours after exposure to the bacteria, even if the person is asymptomatic, and during the acute phase of the rash and fever; it ends after the temperature drops for at least 12 hours.

• Signs and symptoms of scarlet fever include a fever of 101°F or higher, a sandpaper-like rash, strawberry tongue, and other relatively non-specific signs such as nausea, vomiting, headache, glandular enlargement, and body aches.

• The prognosis for scarlet fever, with timely and effective treatment, is very favorable; such treatment usually prevents complications. However, with the development of complications, the prognosis depends on the damage to other organs.

• The chance of contracting scarlet fever can be reduced or prevented by washing your hands thoroughly and not sharing utensils, towels, or other personal hygiene items. There is no vaccine for scarlet fever in humans.

The modern name for scarlet fever is still scarlet fever, and it continues to exist today. It is also known as streptococcal pharyngitis or group A beta-hemolytic streptococcus.

Methods of infection with scarlet fever

Scarlet fever is contracted by individuals when they come into contact with group A streptococci bacteria. These Gram-positive coccoid organisms can produce erythrogenic toxin (red-colored toxin) by infecting various parts of the body. This toxin causes a characteristic red, sandpaper-like skin rash.

Studies have shown that approximately 80% of children who have reached the age of 10 develop protective antibodies against streptococcal exotoxin throughout their lives. These bacteria can also cause other symptoms and/or diseases such as impetigo, skin desquamation, myositis, acute rheumatic fever, and necrotizing fasciitis.

The incubation period for scarlet fever has a wide range and ranges from about 12 hours to seven days. Humans are contagious during the incubation period and during the acute phase of the disease. The rash itself with scarlet fever is not a source of infection.

Risk factors for developing scarlet fever include overcrowding in facilities such as schools, dormitories, and institutions. Scarlet fever usually affects children aged 5-15 years, although it can occur in older children and adults. In children under 2 years of age, scarlet fever is rare due to the presence of maternal antibodies.

The period of contagiousness of scarlet fever occurs during the incubation period, approximately 12 hours to seven days after initial contact with the bacteria, and during the acute phase, when rash and fever appear.

What are the symptoms and signs of scarlet fever?

Signs of scarlet fever may present with the following symptoms: sore throat, fever (38°C or higher), and a widespread red rash (exanthema) with a sandpaper-like texture. In addition, the tongue may have a strawberry appearance (red with small bumps), which is called a strawberry tongue. Some patients may have a whitish coating on the tongue or throat, as well as enlargement of the lymph nodes and glands. Headache, abdominal pain or discomfort, nausea, vomiting and/or body aches may occur. The rash of scarlet fever is sometimes described as “goose bumps (papule) on burnt skin” or “boiled lobster skin”.

How do doctors diagnose scarlet fever?

In most cases, the provisional diagnosis of scarlet fever is based on the patient’s history and physical examination. For example, a physical examination may reveal signs such as Pastia’s or Thompson’s lines, which appear in the skin folds of the armpits and groin and are pink or red in color. These lines may appear before the rash develops and may remain pigmented after the skin has been exfoliated. In some cases, a doctor may take a swab or culture from a throat, wound, or other infection to determine the presence of group A streptococci. However, the diagnosis is often based on the typical symptoms of scarlet fever without the need for laboratory tests. If complications arise, consultation with an infectious disease specialist may be required. If group A streptococci are not found, then the symptoms of scarlet fever are likely related to another underlying disease.

How is scarlet fever treated?

Treatment for scarlet fever involves the use of antibiotics that are effective against group A streptococci. Oral penicillin, such as amoxicillin, is usually recommended for about 10 days. In some cases, a single injection of penicillin G benzathine (bicillin L-A) may be required, especially if the patient cannot take antibiotics by mouth. Other antibiotics such as cephalosporins (eg cephalexin) may also be effective. It is important to take the full course of antibiotics prescribed, even if symptoms improve, to prevent complications and relapses.

What are the consequences of scarlet fever?

Complications of scarlet fever can include poststreptococcal glomerulonephritis (a kidney disease) and rheumatic fever (an inflammatory disease that affects the heart, joints, skin, and brain). Rheumatic complications usually begin to appear two to three weeks after the onset of infection and are most common in children aged 6 to 15 years. Kidney complications can begin one to two weeks after a throat infection or three to six weeks after a skin infection and are more common in adults. However, with timely and proper antibiotic treatment, long-term complications of scarlet fever are rare.

Is scarlet fever fatal?

With timely and adequate antibiotic treatment, the prognosis for scarlet fever is usually favorable. Most patients recover completely, and skin symptoms gradually disappear over several weeks. However, if left untreated, scarlet fever can become serious and even fatal. Currently, the mortality rate for scarlet fever is low due to early detection and antibiotic treatment.

Is it possible to prevent scarlet fever? Is there a vaccine for scarlet fever?

The best way to prevent scarlet fever is to practice good hand hygiene. Washing your hands regularly with warm water and soap helps reduce the risk of infection and the spread of bacteria. It is also recommended to avoid sharing utensils, towels, and other personal items with infected people. Scarlet fever is transmitted through droplets of air from person to person, so close contact with patients should be avoided. Patients who take antibiotics and do not have a fever within 24 hours are considered non-infectious. There is currently no commercially available scarlet fever vaccine for humans.

Lassa fever – Nigeria

Outbreak summary

Nigeria is currently experiencing a major outbreak of Lassa fever, during which during the period from the 1st to the 15th epidemiological week of 2023 (week ending 16 April) 4702 suspected cases, five probable cases and 877 confirmed cases. Among cases with a confirmed diagnosis, 152 deaths were registered (case fatality rate 17%). Lassa fever is endemic in Nigeria and parts of West Africa, where the African polynipple rat is a major reservoir of the Lassa virus.

The implementation of anti-epidemic measures in connection with the current outbreak is difficult because the country currently has to respond to a number of emergencies at the same time.

The disease is characterized by a wide variety of symptoms, and therefore the diagnosis can be difficult. Most infections (about 80%) caused by the Lassa virus are asymptomatic or mild. However, the infection can cause severe disease with multiple organ dysfunction, with or without bleeding. Therefore, laboratory testing is required to confirm the diagnosis.

Laboratory-confirmed cases of Lassa fever have been reported in states bordering Cameroon (Adamawa, Benue, Cross River and Taraba) and Benin (Oyo and Niger). The overall risk at the regional and global levels is assessed as low because the main route of transmission for Lassa virus is contact with food or household items contaminated with rat feces. There is a low level of human-to-human transmission.

Lassa fever epidemiological situation

Nigeria is experiencing a major outbreak of Lassa fever with 4,702 suspected cases, five probable cases, and 877 confirmed cases between epidemiological weeks 1 and 15 of 2023 (week ending 16 April). Among cases with a confirmed diagnosis, 152 deaths were registered (case fatality rate 17%). The number of cases with a confirmed diagnosis increased by 20% compared to the same period in 2022 (733 cases).

Cases have been reported in 101 Local Government Areas (LGAs) in 26 of 36 states, including the Federal Capital Territory (FCT). Three states have a high concentration of confirmed cases (72%): Ondo (32%), Edo (29%) and Bauchi (11%). Laboratory-confirmed cases of Lassa fever have been reported in states bordering Cameroon (Adamawa, Benue, Cross River and Taraba) and Benin (Oyo and Niger).

Lassa fever epidemiology

Lassa fever is an acute viral hemorrhagic disease caused by the Lassa virus. The virus is most commonly transmitted to humans by direct contact with infected rodents of the genus Mastomys or by contact with food or household items contaminated with the urine or droppings of infected rodents. Accordingly, the virus is transmitted to a person through cuts and scratches or by inhalation of dust particles contained in the air. Person-to-person transmission can occur through direct contact with the blood or body fluids of an infected person, but is rare. Secondary transmission in health care settings can occur when the disease is detected late and treatment is started, and when adequate infection prevention and control (IPC) measures are not followed.

Most Lassa virus infections (about 80%) are asymptomatic or mild, but in about 20% of cases the virus can cause severe disease, sometimes with multi-organ dysfunction with or without bleeding. Without proper laboratory tests, the diagnosis of Lassa fever is difficult due to the variety of possible symptoms of the disease, from asymptomatic infection to multiple organ failure and death.

In patients hospitalized with severe disease, the case fatality rate is typically between 1% and 15%. The disease is particularly severe in the later stages of pregnancy, with rates of maternal death and/or fetal loss exceeding 80% during the last trimester. Maintenance therapy with rehydration and symptomatic treatment in the early stages of the disease is essential to increase the chances of survival. The antiviral drug ribavirin is used to treat Lassa fever, but its effectiveness has not been proven. To date, there is no vaccine against Lassa fever.

The disease was first reported in 1969 in the state of Borno in Nigeria, where it is endemic. Transmission of infection is observed throughout the year. However, large seasonal outbreaks occur during the dry season, usually from December to April.

In 2023, 42 cases were reported among healthcare workers in 11 states during the period from the 1st to the 15th epidemiological week. During epidemiological week 15, 2023 (April 10-16), 141 new cases with suspected Lassa fever, nine new confirmed cases and one new confirmed case with a fatal outcome (case fatality rate of 11%) were reported.

The implementation of anti-epidemic measures in connection with the current outbreak is difficult because the country currently has to respond to a number of emergencies at the same time. These include outbreaks of COVID-19, diphtheria, meningitis, measles, cholera and ongoing humanitarian crises. In addition, the country is forced to solve security problems, which makes it difficult to carry out anti-epidemic measures in a timely manner.

Public health response

The Nigerian Centers for Disease Control and Prevention (NCDC) and health authorities in the affected states are taking the lead in controlling the outbreak. On January 28, 2023, the National Center for Emergency Situations (ECS) of the NCDC became operational, and Rapid Response Teams (RRTs) were sent to the states of Bauchi, Benue, Ebonyi, Edo, Ondo and Taraba.

Anti-epidemic measures include:

• surveillance: detection, monitoring of cases and outbreaks, and laboratory testing;
• assistance to sick people;
• preventive measures: educating the public about personal hygiene, food safety and rodent control in the place of residence and work;
• Response: prescribing antivirals, supportive care to confirmed patients, and tracking contracted individuals to identify those who may have been exposed to the virus.

To strengthen the response to the outbreaks of Lassa fever in Nigeria, the NCDC, in collaboration with WHO and other partners, developed a national outbreak prevention and control action plan. This plan includes measures to improve surveillance, increase the efficiency and capacity of national laboratories, increase public awareness and ensure greater access to treatment and care services for patients.

WHO risk assessment

Lassa fever is an acute hemorrhagic fever disease that is endemic in West Africa. Confirmed outbreaks and sporadic cases of Lassa fever have been reported in Benin, Burkina Faso, Côte d’Ivoire, Guinea, Ghana, Liberia, Mali, Sierra Leone, Togo and Nigeria. In some regions, rodents of the genus Mastomys are eaten.

Nigeria is a Lassa fever endemic country and has a developed capacity to control outbreaks of this disease, but the overall risk at the national level is currently assessed as high due to several factors:

• increase in the number of confirmed cases compared to the same period in previous epidemic seasons;
• reduced national capacity due to the need to respond to a range of ongoing health emergencies, which has overburdened the country’s health system and limited the availability of medical resources;
• lack of personal protective equipment (PPE), which poses a high risk of healthcare-associated infections;
• delays in transporting biomaterial specimens for laboratory testing in several states resulting in delayed confirmation of diagnosis and provision of treatment and care;
• Poor health infrastructure, poor sanitation and continued presence of virus-carrying rodents;
• insufficient information and education of the public and health care workers about Lassa fever, which can lead to further delays in diagnosis and treatment and increase the risk of infection and the likelihood of death.

Overall regional and global risk is assessed as low because Lassa virus is transmitted to humans primarily from animals and there is low human-to-human transmission.

WHO recommendations

Prevention of Lassa fever involves good hygiene at the community level to control the entry of rodents into homes. Effective measures include keeping grains and other foodstuffs in rodent-proof containers, removing waste disposal sites from homes, keeping homes clean, and keeping pet cats.

When caring for patients in health care settings, regardless of the suspected diagnosis, health care workers should always follow standard infection prevention and control measures. These measures include practicing hand and respiratory hygiene, using personal protective equipment against splashes or other contact with infectious materials, using safe injection practices, and ensuring the safe burial of the deceased.

Healthcare workers caring for patients with suspected or confirmed Lassa fever should take additional infection control measures to prevent contact with patients’ blood and body fluids, and with contaminated surfaces or materials, such as clothing and bedding. When in close contact with patients with Lassa fever (within one meter), healthcare workers need face protection (face shield or surgical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves are required for some medical procedures).

There are currently no registered vaccines to protect people against Lassa fever. In the early stages of the disease, the antiviral drug ribavirin may be an effective treatment for Lassa fever, but the evidence is conflicting. Evidence on the effectiveness of ribavirin as a post-exposure prophylactic for Lassa fever is not available.

WHO continues to recommend that all Lassa fever endemic countries improve their early case detection and treatment in order to reduce the number of deaths.

Based on available information, WHO does not recommend any restrictions on passenger or trade traffic for Nigeria.

Additional information

• WHO. Health issues. Lassa fever (in English)
• WHO.