In a follow-up on the measles outbreak in Madagascar, the outbreak case count has risen to 28,747 since early October. The vast majority of the outbreak cases have been reported in children.

Of this total, 80 fatalities have been reported.
According to the World Health Organization (WHO), about 55% of cases are either unvaccinated or of unknown vaccination status.
Seventy percent of health districts in all 22 regions in Madagascar have been affected. The health district of Antananarivo-Renivohitra is the most affected.
While officials say the situation is improving, the risk of the outbreak spreading to the few remaining unaffected regions of the country remains.
Although the first phase of the reactive vaccination campaign progressed well (25 health districts from 14-18 January 2019, targeting 1.48 million children), there is still a shortage of vaccines and funds for response in those districts at risk, and funding gaps need to be filled for phases two and three of the campaign, planned for February through April 2019.
In addition, communication to prevent anti-vaccine rumors needs to be strengthened.
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