Madagascar is approaching 300 suspected or confirmed cases of monkeypox, with the Majunga region on the front line.

Mis à jour le 21 May 2026

An unprecedented health crisis is shaking Madagascar at the start of 2026, as the monkeypox epidemic, or Mpox, reaches an alarming level with nearly 290 reported cases, the majority in the Majunga region. The rapid spread of this disease, initially considered rare, highlights a failure of the health surveillance system in the face of a threat that is now unfolding on a worrying scale nationwide. While the majority of cases are concentrated in the Majunga region, the spread to other areas such as Antananarivo, Fianarantsoa, ​​and Mahatsinjo illustrates a contagion that seems to be spiraling out of control, exacerbating the vulnerability of the health system and dramatically raising the issue of resilience to emerging diseases. Malagasy health authorities, already mobilized, emphasize the environmental and community nature of the transmission, stressing the need for a collective response.

A worrying increase in cases: Madagascar’s health sovereignty in the face of monkeypox

The official tally of this epidemic reveals that among the 78 confirmed cases, thirty were recorded in the city of Majunga alone, making this region the epicenter of the health crisis. The situation is worsening to the point where screening tests show a continuous rise in the positivity rate, which peaked at over 50% this week, compared to an average of less than 42% the previous day. This versatility of the virus, capable of spreading rapidly through direct contact with skin lesions or via contaminated objects, underscores the increased vulnerability of the Malagasy population to a pathogen presented as not very lethal but highly transmissible. The increase in suspected cases is all the more alarming given that all regions of the country have reported at least one case, indicating widespread community transmission and highlighting the need for exceptional measures.

	Regions	Suspected Cases
Confirmed Cases	Majunga 🏙️	70+
61	Antananarivo 🛫	40
8	Fianarantsoa 🌄	20
1	Mahatsinjo 🌾	15
1	Other regions	alternating between 5 and 15

at least one case

The challenges of monkeypox transmission: modes and risks

In Madagascar, transmission occurs mainly through close contact—directly touching lesions or via contaminated objects—but also through sexual contact or via the respiratory route in specific circumstances. Droplet transmission, although rare, remains a concern, particularly in close proximity or during large gatherings. The disease, often mild, can nevertheless lead to complications, particularly in vulnerable populations such as children, the elderly, or immunocompromised individuals.

The virus incubates for an average of twelve days, during which time the patient is asymptomatic. This is followed by a febrile phase, accompanied by characteristic skin rashes that last from two to four weeks, often accompanied by pain or general malaise. The rapid transmission during these symptomatic phases requires increased responsiveness from healthcare professionals to contain the spread. While severe cases exist in certain populations, their frequency remains low—below 0.2% during the 2022 global epidemic—but vigilance must be maintained.

Health measures deployed: a collective response to the epidemic in Madagascar

Since the identification of the first cases, Madagascar has launched a series of measures to curb the spread of Mpox. Among these, strengthening border controls is essential, including the collection of traveler contact tracing forms from travelers arriving from at-risk areas (“Madagascar” in this context), particularly those from Majunga or other affected areas. The implementation of systematic screening, as well as information campaigns to raise public awareness about modes of transmission, has also been accelerated.

Specific strategies have been adopted to better equip the health system to face this growing threat. Emphasis is placed on training healthcare personnel in triage procedures, providing smallpox vaccines, and deploying mobile teams to monitor suspected cases. The ongoing crisis has also prompted the mobilization of international resources to support Madagascar, particularly through assistance with case management and crisis communication.

The Role of Vaccines in Combating the Spread of Monkeypox in Madagascar

Faced with this epidemic, vaccination is a major weapon in reducing transmission and minimizing the impact of the disease. Although human smallpox vaccination has been abandoned in many countries since its eradication was declared, it is now being reassessed in the context of Mpox. Madagascar has thus begun acquiring and distributing vaccines specifically designed to prevent monkeypox, targeting in particular those who are exposed or at high risk.

Health authorities are also encouraging awareness campaigns about the importance of vaccination to limit contagion. The strategy is to intervene quickly before the virus becomes uncontrollable. However, the limited availability of vaccines and complex logistics must be overcome to ensure sufficient coverage. International mobilization, supported by organizations such as the WHO, could make a difference in the face of this health crisis, which requires careful and coordinated management.

	The Challenges of Epidemiological Surveillance and Prevention in Madagascar
Faced with this resurgence of monkeypox cases, epidemiological surveillance must be strengthened, particularly by improving rapid and reliable diagnostic capabilities. The difficulty lies in the wide geographical distribution of suspected cases in a region with often fragile infrastructure.	It is essential to broaden the national debate on prevention by involving all segments of society and strengthening community engagement. Awareness campaigns must be disseminated in all local languages, and targeted communication campaigns must emphasize adherence to hygiene and social distancing measures. Implementing an epidemiological monitoring system that integrates all local data will allow for the effective anticipation and control of the spread.
	Key Strategies
Description	Strengthening health controls ✈️
Strict border surveillance, traceability records	Mass vaccination 💉
Targeting at-risk populations, priority vaccination	Information and awareness-raising 📢

Communication campaigns, community education

Improving diagnostic capacities 🧬

Staff training, laboratory equipment

International mobilization 🌍

WHO support, sharing of best practices

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A global threat: Madagascar’s role in the fight against global monkeypox

While Madagascar is fighting local spread, the phenomenon extends far beyond its borders. The recent discovery of a case in Mayotte and the fear of wider transmission in the Indian Ocean region complicate a situation that demands heightened global vigilance. The vulnerability of this part of the world, facing a disease that is accelerating without borders, highlights the need for strengthened international cooperation.

In this sense, the situation in Madagascar should be seen as a warning sign for the international community. The variability of the virus, the increased mobility of populations, and the inadequacy of medical infrastructure in certain areas demand collective awareness. International solidarity, through financial, logistical, or human aid, appears to be a prerequisite for overcoming this crisis, which threatens to become an unavoidable pandemic.

https://www.youtube.com/watch?v=2whzp5v0ns0

Frequently Asked Questions about the Monkeypox Crisis in Madagascar

What is the current situation in Madagascar regarding monkeypox?

Madagascar is experiencing an alarming resurgence with nearly 290 reported cases, concentrated mainly in the Majunga region, requiring a strengthened health response.

How is the disease transmitted, and what are the risks for the population?

The disease is mainly transmitted through direct or indirect contact with lesions, in the context of close or sexual contact, with a low risk of lethality but a high risk of dissemination. What are the recommended prevention measures?

Preventive measures include vaccination, rigorous hygiene, wearing masks in certain situations, and reducing risky contacts. What measures are being implemented to contain the epidemic?

🔗 Sources & références

Pour aller plus loin, consultez les sources citées dans cet article :

• 🌐What measures are being implemented to contain the epidemic? — la1ere.franceinfo.fr