First documented mpox outbreak


​Madagascar is experiencing its first documented mpox outbreak, with 111 confirmed cases and 263 suspected cases reported as of January 19, 2026. The outbreak began in December 2025 in the Mahajanga I urban commune in the Boeny region, with the first cases confirmed on December 30, 2025.

Outbreak Progression


The outbreak has rapidly expanded from the initial epicenter. As of January 2, 2026, only five laboratory-confirmed cases had been reported, demonstrating significant acceleration in case numbers over the following three weeks. The virus has since spread to the capital region, with the Analamanga region (which includes Antananarivo) now ranking second among regions with the highest number of confirmed cases.


Transmission and Symptoms


Mpox spreads through direct skin contact with wounds and lesions, contaminated materials, respiratory droplets, and body fluids.The disease is strongly associated with sexual transmission. Infections typically cause fever, rash, and swollen lymph nodes. The incubation period can last up to 21 days, which complicates early detection, particularly when symptoms like genital rashes go unnoticed. 


Response Measures


Health authorities have implemented multiple containment strategies, including establishing public health emergency operation centers across all regions, installing health checkpoints on major roads at exits from affected areas, and strengthening protective measures in schools and tourist sites. A checkpoint on National Route 4 connecting Antananarivo to Mahajanga screens all travellers for fever and visible skin lesions, though some rashes can be missed.


Confirmed cases must observe strict isolation for three weeks, and contacts must remain confined at home for 21 days. As of January 19, no deaths linked to the outbreak had been reported.The neighbouring Comoros has required travellers from Madagascar to present medical certificates upon entry. 

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