Plague in Madagascar
Madagascar usually notifies 200 to 400 plague cases a year, mostly bubonic, in the central and northern highlands above 800 metres. It reported 1,482 suspected cases and 307 deaths to WHO in 2019-2025, a fatality of 20.7 percent, the highest of any country. The 2017 epidemic was unusual for its urban pneumonic spread in Antananarivo and Toamasina.
Updated:
Situation now
The 2026-27 season began in September; no official counts have been published yet. Recent cases cluster in Amoron'i Mania: 12 cases and 6 deaths in February-May 2025 and a fatal pneumonic case in Ambositra in January 2026.
Authority: Institut Pasteur de Madagascar
Reported to WHO, 2019 to 2025
| 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Total | |
|---|---|---|---|---|---|---|---|---|
| Suspected | 217 | 122 | 201 | 311 | 378 | 166 | 87 | 1,482 |
| Confirmed | 106 | 60 | 100 | 131 | 174 | 71 | 51 | 693 |
| Deaths | 52 | 30 | 46 | 59 | 59 | 32 | 29 | 307 |
Source: WHO Weekly Epidemiological Record 101(38), 25 Sep 2026, Table 9.
Natural foci
Madagascar central highlands
ActiveHosts: Black rats (Rattus rattus), Xenopsylla cheopis
Central and northern highlands above 800 m, seasonal from about September to April. 1,482 suspected cases and 307 deaths reported to WHO in 2019-2025, the highest fatality of any country. The 2017 urban pneumonic epidemic caused 2,417 cases and 209 deaths.
Recent events
A 9-year-old girl with pneumonic plague dies in Ambositra district (rapid test positive).
Ministry of Health declares the acute urban pneumonic epidemic contained: 2,417 cases and 209 deaths since 1 August.
Latest signals
Headlines attributed to Madagascar in the last 45 days. Not verified by us.