Antananarivo
Capital and largest city of Madagascar.
Antananarivo is an urban centre of Madagascar's clade Ib mpox epidemic, which produced over half the world's confirmed mpox cases in July 2026; WHO said on 14 September the outbreak was not under control.
Last refreshed: 4 October 2026
Timeline for Antananarivo
Mentioned in: Madagascar logs half July's mpox cases
Pandemics and BiosecurityBackground
Antananarivo is the capital and largest city of Madagascar. Twice in a decade it has been at the centre of a major urban epidemic: plague in 2017 and clade Ib mpox in 2026.
The city was the main site of the 2017 urban pneumonic plague epidemic. Between 1 August and 26 November 2017, 2,414 suspected cases were reported, 78% of them pneumonic, and Antananarivo and Toamasina were worst affected (Institut Pasteur). The plague spread from person to person in the cities rather than in its usual rural pattern. Antibiotics and contact tracing ended it within about three months.
mpox in 2026 follows a similar urban pattern. WHO reports cases across all ages and both sexes, unlike the sexual-network spread behind Europe's clade I cases, and reads 67% test positivity as a sign that surveillance is missing many infections.
The capital carries Madagascar's mpox outbreak
Antananarivo is one of the urban centres of Madagascar's 2026 mpox outbreak. In June the city recorded 66 new cases in the latest reporting period, and the country's eighth death, a 20-year-old immunocompromised man, occurred there, according to GAT on 25 June.
The outbreak has since spread FAR beyond the capital. WHO's situation report of 14 September traced it to 75 of the island's 115 districts by 16 August. WHO judges the outbreak not under control. It cites vaccine stockouts and broken cold chains, and reads test positivity of 67% as surveillance too weak to find most cases.