In Nigeria and across Africa, most patients with fever have malaria. Every year, some have Lassa fever. Now, with an imported Ebola case in Abuja and outbreaks in DR Congo and Kenya, nurses at triage need a simple way to decide who to isolate first.
They look alike at first
| Malaria | Lassa fever | Ebola | |
|---|---|---|---|
| Spread | Mosquito bite | Contact with rodent urine/droppings; person to person through body fluids | Person to person through body fluids; contact with the dead |
| Incubation | Usually 7–30 days | About 2–21 days | 2–21 days |
| Early signs | Fever, headache, weakness, body aches, often vomiting | ||
| Clues | Positive RDT; responds to antimalarials | Sore throat, chest or back pain, facial swelling, hearing loss later; peaks in the dry season | Severe vomiting and diarrhoea, rapid decline; travel or contact history |
The questions that matter most
- Have you travelled in the last 21 days, including to or through DR Congo, Uganda (Entebbe) or Kenya?
- Have you had contact with a sick person with fever or bleeding, or attended a funeral?
- Have you had contact with rats or rodent droppings, or with a Lassa case?
- Are you a health worker who cared for someone with an unexplained fever?
Practical rules
- Any yes to questions 1, 2 or 4, plus fever, means isolate first and call your response team before routine procedures.
- A positive malaria test doesn’t rule out Ebola or Lassa. Patients can have both.
- Fever not improving after 48–72 hours of antimalarials should make you think again.
- Use standard precautions with every patient, because you won’t always know who is infectious.
Related: Ebola signs and nursing care · Ebola PPE guide · Hand hygiene
Based on WHO and NCDC guidance. Educational content: follow your national triage and case definitions. In Nigeria, call NCDC on 6232.