Genomic Analysis of Lassa Virus during an Increase in Cases in Nigeria in 2018

N Engl J Med. 2018 Nov 1;379(18):1745-1753. doi: 10.1056/NEJMoa1804498. Epub 2018 Oct 17.


During 2018, an unusual increase in Lassa fever cases occurred in Nigeria, raising concern among national and international public health agencies. We analyzed 220 Lassa virus genomes from infected patients, including 129 from the 2017-2018 transmission season, to understand the viral populations underpinning the increase. A total of 14 initial genomes from 2018 samples were generated at Redeemer's University in Nigeria, and the findings were shared with the Nigerian Center for Disease Control in real time. We found that the increase in cases was not attributable to a particular Lassa virus strain or sustained by human-to-human transmission. Instead, the data were consistent with ongoing cross-species transmission from local rodent populations. Phylogenetic analysis also revealed extensive viral diversity that was structured according to geography, with major rivers appearing to act as barriers to migration of the rodent reservoir.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Bayes Theorem
  • Disease Reservoirs
  • Female
  • Genetic Variation
  • Genome, Viral*
  • Humans
  • Lassa Fever / epidemiology
  • Lassa Fever / transmission
  • Lassa Fever / virology*
  • Lassa virus / genetics*
  • Male
  • Markov Chains
  • Middle Aged
  • Nigeria / epidemiology
  • Phylogeny
  • Phylogeography
  • RNA, Viral / analysis*
  • Rodentia
  • Sequence Analysis, RNA
  • Zoonoses / transmission


  • RNA, Viral