Toamasina
Madagascar's main seaport, on the east coast.
Toamasina was the worst-hit area of Madagascar's clade Ib mpox outbreak in June 2026, with 133 new cases in one reporting period; by 16 August the island had 3,436 confirmed cases and 22 deaths.
Last refreshed: 4 October 2026
Timeline for Toamasina
Mentioned in: Madagascar logs half July's mpox cases
Pandemics and BiosecurityBackground
Toamasina is Madagascar's main seaport, on the island's east coast.
In 2026 it sat at the centre of the island's mpox epidemic. Reporting from 25 June 2026 put Toamasina as the worst-hit area, with 133 new cases in the latest period. Across the island, confirmed clade Ib cases reached 3,436 by 16 August, with 22 deaths, and infections had turned up in 75 districts out of 115. In July alone Madagascar supplied 703 of the 1,370 confirmed mpox cases reported worldwide. Two in three tests came back positive, a sign that many cases go unrecorded, and WHO cites vaccine stockouts and broken cold chains.
Toamasina faced an urban epidemic once before, in 2017. It was one of two cities worst hit by that year's pneumonic plague outbreak, which began with a patient WHO died of respiratory distress while travelling by bush taxi from the Central Highlands to Toamasina, according to Institut Pasteur. Person-to-person spread ran through both Toamasina and Antananarivo, and within roughly three months antibiotics and contact tracing had stopped it.
Toamasina sits at Madagascar's mpox centre
WHO's mpox situation report 69, published on 14 September 2026, found Madagascar had reported 703 of the world's 1,370 confirmed cases in July, all of them clade Ib. Toamasina had been the island's worst-hit area in reporting from 25 June, with 133 new cases in a single period.
By 16 August Madagascar counted 3,436 confirmed cases and 22 deaths across 75 of its 115 districts. In The Week to 16 August, 67% of tests came back positive, which WHO read as surveillance missing cases. Toamasina has met an urban epidemic before: in 2017 pneumonic plague spread person to person there and in Antananarivo.