Madagascar Mpox Cases Rise: Awareness & Growing Concerns

Madagascar is currently facing a growing outbreak of mpox, with cases steadily increasing since its first documented occurrence on December 30, 2025. Health officials are working to contain the spread of the virus, which is impacting both adults and children.

Rising Case Numbers and Vulnerable Populations

As of January 19, 2026, the Ministry of Public Health in Madagascar reported approximately 261 suspected cases and 94 confirmed cases of mpox. UNICEF data indicates that, at that time, 8 confirmed cases involved children, with an additional 84 suspected cases in the pediatric population. More recent data, as of January 29, 2026, shows 214 confirmed cases nationally. The number of confirmed cases has since risen to 111, with 263 suspected cases reported as of January 20, 2026.

While the majority of cases are currently affecting adults, with a median age of 23, children under the age of five are considered particularly vulnerable. This concern is underscored by experiences in previous mpox outbreaks in Africa, notably in the Democratic Republic of Congo (DRC) in 2024, where children were nearly four times more likely to die from the virus than adults. Malnourished children in areas with poor sanitation and limited access to healthcare face an even greater risk of contracting and succumbing to mpox.

Geographic Distribution and Viral Clade

The outbreak is currently concentrated in the Boeny region, with 163 confirmed and 87 suspected cases. Smaller clusters have been identified in other regions, including Analamanga (25 confirmed, 8 suspected), Vakinankaratra (9 confirmed, 4 suspected), Haute Matsiatra (9 confirmed), Melaky (4 confirmed, 1 suspected), Amoron’i Mania (1 confirmed), Atsimo Andrefana (1 confirmed, 1 suspected), Vatovavy (1 confirmed), and Betsiboka (1 confirmed, 5 suspected). The Ministry of Public Health has confirmed that the outbreak involves Mpox Clade 1b.

Public Health Response and Awareness

Health workers in Madagascar are actively engaged in efforts to contain the outbreak. A recent U-Report Madagascar survey, conducted between January 9 and January 19, 2026, engaged 42,000 young people, gathering over 11,400 responses regarding mpox awareness and preventative measures. The survey results revealed a high level of perceived risk (77%), but also highlighted gaps in knowledge and inconsistent adoption of preventative practices. Specifically, hand hygiene was not widely practiced, and children were often not recognized as being at risk.

Despite these gaps, the survey indicated a strong intention to change behavior (93%) and some level of adoption of preventative measures (88%). However, engagement was lowest among individuals aged 15-24, and there were regional disparities in awareness and practice. Vaccine acceptance was moderate, with 54% of respondents expressing willingness to be vaccinated, and one-third remaining undecided.

International Impact and Travel Concerns

The outbreak is not limited to Madagascar. As of February 10, 2026, two confirmed cases of mpox linked to travel to Madagascar have been reported in Réunion. Authorities in Réunion are conducting contact tracing and implementing a reactive vaccine campaign. No epidemiological link has been established between these two cases.

Mpox, formerly known as monkeypox, is a viral infection that can cause a range of symptoms, including fever, headache, muscle aches, swollen lymph nodes, and a characteristic rash. The virus spreads through close contact with an infected person or animal, or with materials contaminated with the virus, such as clothing or bedding.

The current situation in Madagascar underscores the importance of continued surveillance, rapid response measures, and public health education to control the spread of mpox and protect vulnerable populations. Further updates will be provided as the situation evolves.