Measles cases rise in three Malawi districts, outbreak response scaled up

Malawi is facing an escalating measles outbreak concentrated in three districts, with the Ministry of Health logging 73 measles alerts through the Integrated Disease Surveillance and Response (IDSR) system in Epidemiological Week 27 (29 June to 5 July 2026). The International Federation of Red Cross and Red Crescent Societies (IFRC) says the outbreak is still spreading and has designated Balaka, Dedza and Nsanje as the highest-priority districts for immediate intervention.

Key facts

• Trigger date: 20 July 2026, as recorded in the IFRC's DREF Operational Update (MDRMW027), published 30 October 2026
• Most affected districts: Nsanje, Dedza and Balaka
• Case numbers: 211 confirmed and epidemiologically linked cases in Nsanje since February 2026, 90 in Dedza since July 2026, and 82 laboratory-confirmed cases in Balaka since January 2026
• Who is affected: more than 85% of confirmed cases are children under 15
• Vaccination status: over 70% of cases were unvaccinated or of unknown vaccination status

Where is the outbreak concentrated?

Transmission has shifted from sporadic cases earlier in 2026 to localised outbreaks in several districts. The IFRC identifies the catchment areas of Comfort and Khwisa health facilities in Balaka District, Golomoti and Kaundu in Dedza District, and Osiyana, Ndamera, Nsanje and Trinity health facilities in Nsanje District as the main hotspots.

New laboratory-confirmed cases are still being reported, which the IFRC says indicates continuing transmission and a rising risk of expansion into neighbouring districts.

Who is most at risk?

Children under five are described as particularly vulnerable because of low vaccination uptake, malnutrition and limited access to health services. In parts of Nsanje, religious beliefs and vaccine hesitancy have delayed treatment-seeking and reduced acceptance of vaccination services, which the IFRC says increases the risk of severe illness and preventable deaths.

What is driving the spread?

The IFRC cites low routine immunisation coverage, high numbers of unvaccinated children, delayed health-seeking behaviour, weak community surveillance, inadequate risk communication and widespread misinformation about vaccination. In Nsanje, cross-border population movement along the Malawi-Mozambique border has intensified the risk of spread, while shortages of trained health workers, volunteers and operational resources have limited surveillance and response.

District health services are under added pressure from demand for surveillance, laboratory testing, case management, contact tracing and vaccination outreach.

What this means for travellers

Anyone planning travel to Balaka, Dedza or Nsanje districts should be aware that the IFRC reports active measles transmission there and a high likelihood of further spread unless urgent interventions are carried out. Given that more than 70% of confirmed cases were unvaccinated or of unknown vaccination status, travellers should check their own measles vaccination status before visiting affected areas.

The IFRC warns that without a rapid scale-up of surveillance, community engagement, social mobilisation and immunisation activities, transmission could intensify in these districts and reach surrounding areas. No additional district-level restrictions for travellers have been announced.