The island nation of Madagascar is grappling with a growing mpox outbreak, with health officials reporting 1,186 notified cases – including 539 confirmed – since the beginning of the epidemic in mid-December 2025. The outbreak, a first for the country, is prompting a public health response that includes vaccination efforts and heightened surveillance. This situation underscores the ongoing global challenge of managing mpox, even as cases have declined in many other parts of the world.
The outbreak began in epidemiological week 51 of 2025, according to ReliefWeb, and has steadily expanded across the country. While initially concentrated in the Boeny region, the virus has now been detected in 16 of Madagascar’s 23 regions, including the capital region of Analamanga. The rapid spread highlights the importance of swift and coordinated public health interventions to contain the disease. Understanding the transmission dynamics and risk factors within the Malagasy population is crucial for effective control.
Mpox in Madagascar: A Rapidly Evolving Situation
Mahajanga I district in the Boeny region remains the epicenter of the outbreak, accounting for a significant 52% of confirmed cases – 280 out of the 539 confirmed nationally as of March 10, 2026. Antananarivo Renivohitra follows with 74 confirmed cases (14%), while Antananarivo Atsimondrano has reported 25 cases (5%), Toliara 22 cases (4%), and Fianarantsoa 15 cases (3%). This geographic distribution indicates that the virus is not confined to a single area and requires a broad-based response.
As of March 10, 2026, 374 patients have reportedly recovered from mpox in Madagascar. However, the outbreak has tragically claimed its first life: a three-year-vintage child died on February 28, 2026, at the Cenhosoa hospital center, as reported by Franceinfo. This fatality underscores the potential severity of mpox, even in previously unaffected populations, and the need for prompt medical care.
Vaccination Campaign Underway
In response to the escalating outbreak, Madagascar has received 30,000 doses of the mpox vaccine, produced by Bavarian Nordic. The vaccine received a favorable opinion from Madagascar’s Technical Advisory Group on Vaccination (GT-CV), aligning with national procedures. UNICEF has been instrumental in supporting the delivery and rollout of the vaccine, emphasizing the importance of international collaboration in addressing global health crises. UNICEF Madagascar confirmed the arrival of the vaccines and their intended use for targeted vaccination of at-risk populations.
The vaccination campaign will prioritize healthcare workers on the front lines and individuals considered to be at higher risk of infection. This targeted approach aims to maximize the impact of the limited vaccine supply and protect those most vulnerable to severe illness. The rollout strategy will be critical in slowing the spread of the virus and preventing further complications.
Understanding Mpox and its Transmission
Mpox, formerly known as monkeypox, is a viral zoonosis – a disease that can spread from animals to humans. It is caused by the mpox virus, which belongs to the orthopoxvirus family. Symptoms typically include a rash that can glance like pimples or blisters, appearing on the face, hands, feet, mouth, and genitals. Other symptoms can include fever, headache, muscle aches, and swollen lymph nodes. The virus spreads through close, personal contact with an infected person or animal, or with materials contaminated with the virus, such as clothing or bedding.
While mpox is generally considered less transmissible than other viruses like measles or COVID-19, it can still spread rapidly in close-contact settings. The current outbreak in Madagascar highlights the importance of public health education and awareness campaigns to inform people about the symptoms of mpox, how it spreads, and how to protect themselves.
Regional Impact and Ongoing Monitoring
The outbreak is not limited to the major urban centers. As of January 12, 2026, cases had been reported across 16 of Madagascar’s 23 regions, demonstrating the widespread nature of the epidemic. The laboratory positivity rate, at 34.8% (24 positive results from 69 completed tests out of 106 specimens collected), suggests significant community transmission. The peak of the outbreak occurred on December 31, 2025, with 23 cases reported in a single day, according to ReliefWeb. This rapid escalation from 34 cases on January 5, 2026, to 92 cases on January 8, 2026, and then to 228 cases by January 12, 2026, demonstrates the virus’s ability to spread quickly.
The Madagascar Ministry of Health is actively monitoring the situation and working with international partners, including UNICEF and the World Health Organization, to implement control measures. These measures include contact tracing, isolation of confirmed cases, and risk communication. Continued surveillance and data collection are essential for understanding the evolving dynamics of the outbreak and adapting the response accordingly.
Challenges and Future Outlook
Several challenges remain in controlling the mpox outbreak in Madagascar. Limited resources, particularly in remote areas, can hinder access to healthcare and vaccination. A lack of awareness about mpox and its transmission can contribute to the spread of the virus. Addressing these challenges requires a sustained and coordinated effort from the government, healthcare providers, and the community.
Looking ahead, the success of the vaccination campaign will be crucial in curbing the outbreak. Continued surveillance, robust contact tracing, and effective risk communication will also be essential. The international community must continue to support Madagascar in its efforts to control mpox and protect its population. The next official update from the Madagascar Ministry of Health is expected in late March 2026, providing further insights into the outbreak’s trajectory and the effectiveness of the ongoing interventions.
Key Takeaways:
- Madagascar is experiencing its first mpox outbreak, with over 1,186 cases reported since December 2025.
- Mahajanga I district is the epicenter of the outbreak, accounting for over half of confirmed cases.
- A vaccination campaign is underway, prioritizing healthcare workers and at-risk populations.
- The outbreak has tragically resulted in one confirmed fatality, a three-year-old child.
- Continued surveillance, international collaboration, and public health education are crucial for controlling the epidemic.
This is a developing story. We encourage readers to share their thoughts and experiences in the comments below. Please also share this article with your networks to raise awareness about the mpox outbreak in Madagascar.
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