Mpox Outbreak Spreads Across the Indian Ocean: Madagascar, Réunion, and Comoros Affected

A resurgence of mpox (formerly known as monkeypox) is unfolding across the Indian Ocean region, with Madagascar at the epicenter and cases now reported in Réunion and the Comoros Islands. This outbreak, beginning in early 2026, signals a concerning shift in transmission dynamics and underscores the need for proactive public health measures.

Current Situation: A Regional Flare-Up

Madagascar is currently experiencing the most significant impact, with ongoing transmission of the mpox virus. As of January 9, 2026, approximately one hundred suspected cases and ten confirmed cases had been observed in Madagascar, primarily concentrated in the coastal region of Mahajanga . Réunion has confirmed its first case, prompting a health alert, and the Comoros Islands have reported four confirmed infections . The outbreak began with five confirmed cases in Madagascar on December 16, all located in Mahajanga .

Shifting Transmission Dynamics

Early in the 2022 global outbreak, mpox primarily affected men who have sex with men. Though, the current cases in Madagascar and the Comoros suggest broader community spread is occurring, potentially involving different transmission routes . This indicates the virus is no longer limited to specific populations and is capable of wider dissemination.

Understanding Mpox

Mpox is an infectious disease caused by the mpox virus, an orthopoxvirus . It typically presents as a rash, which can appear on the face, anogenital region, palms of the hands, and soles of the feet. The rash may spread to other parts of the body and mucous membranes, often accompanied by itching. Other symptoms can include fever, headache, muscle aches, and swollen lymph nodes .

Transmission

Human-to-human transmission occurs through:

• Direct contact with the skin lesions or mucous membranes of an infected person
• Indirect contact with contaminated objects or surfaces (linens, bedding, dishes)
• Transmission via droplets (saliva, sneezing, spittle) is considered unlikely, but possible .

Name Change and Stigma Reduction

In November 2022, the World Health Organization (WHO) changed the name from “monkeypox” to “mpox” to reduce stigma and address concerns about racist and discriminatory language associated with the previous name .

Public Health Response

The Regional Health Agency (ARS) of Réunion is strengthening its vigilance measures in response to the confirmed case . The illness generally has a favorable course and lasts between 2 and 3 weeks. Individuals are contagious from the onset of symptoms until all skin lesions have completely healed, necessitating an isolation period of 3 weeks to prevent further transmission .

Looking Ahead

The ongoing mpox outbreaks in the Indian Ocean region highlight the virus’s persistence and potential for re-emergence. Continued surveillance, proactive public health measures, and a deeper understanding of evolving viral characteristics are crucial for preparedness and effective response. The situation requires a forward-looking approach to mitigate the impact of mpox on affected communities.