Background: Lassa fever (LF) is a zoonotic infection, endemic in Nigeria particularly involving Edo, Ondo, Ebonyi and Bauchi States with sporadic cases from other states. We describe the clinical and epidemiological features of confirmed LF cases from an uncommon location for LF.

Methods: A Retrospective descriptive study of all RT-PCR confirmed LF cases from UzoUwani, Enugu state, who were hospitalized for treatment at the virology center in Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) between January 2021 and October 2022. Data was retrieved from case notes and were analyzed using SPSS version 25.

Results: Out of 50 confirmed LF cases, 16(32%), were from Uzo-Uwani community. The mean age of all patients was $30.8\pm 17.1$ $30.8\pm 17.1$ 30.8+-17.1 30.8 \pm 17.1 $30.8\pm 17.1$ with a range of 0.5 and 62 years. The patients were made up of $11(68.7\mathrm{\%})$ $11(68.7\mathrm{\%})$ 11(68.7%) 11(68.7 \%) $11(68.7\mathrm{\%})$ males and $5(31.3\mathrm{\%})$ $5(31.3\mathrm{\%})$ 5(31.3%) 5(31.3 \%) $5(31.3\mathrm{\%})$ females. History of contact with rats was established in $10(62.5\mathrm{\%})$ $10(62.5\mathrm{\%})$ 10(62.5%) 10(62.5 \%) $10(62.5\mathrm{\%})$ individuals. Patients with severe LF disease were 7(43.7%) and overall case fatality rate was $12.5\mathrm{\%}$ $12.5\mathrm{\%}$ 12.5% 12.5 \% $12.5\mathrm{\%}$ . The leading co-morbid disease conditions were hypertension in 2(12.5%) and diabetes in 1(6.3%) of the patients. Fever 16(100%), vomiting 9 (56.2%), fatigue $8(50\mathrm{\%})$ $8(50\mathrm{\%})$ 8(50%) 8(50 \%) $8(50\mathrm{\%})$ , headache $7(43.7\mathrm{\%})$ $7(43.7\mathrm{\%})$ 7(43.7%) 7(43.7 \%) $7(43.7\mathrm{\%})$ , bleeding (37.5%) and encephalopathy (20%) were the most common presentations. The presence of bleeding and encephalopathy predicted death from LF.

Conclusions: The 2021 outbreak of LF patients managed at AEFUTHA featured a cluster of cases from a traditionally non-endemic region. There is need for an epidemiological study to ascertain the true burden of LF in this community as this may highlight Enugu state as one of the LF endemic states in Nigeria.