Spain on Saturday reported its second monkeypox-related death, one day after announcing what is believed to be the first fatality linked to the current outbreak in Europe.

“Among the 3,750 patients… 120 have been hospitalised and two have died,” the Spanish health ministry said in a report, without specifying the date of the second death.

It said the victims were “two young men”, and that studies were under way to gather more “epidemiologic information” on both cases.

According to the health ministry’s emergency and alert coordination centre, 4,298 people in Spain have been infected, making it one of the world’s hardest-hit countries.

The announcement came after Brazil also reported its first monkeypox-related death on Friday, with previous fatalities confined to Africa where the virus is endemic and was first detected in 1970.

It is unclear if monkeypox caused any of the three deaths, with Brazilian authorities saying its deceased patient suffered from other serious conditions.

The Spanish health ministry recorded a second monkeypox-related death on Saturday, a day after Spain and Brazil reported their first fatalities.

The announcements marked what are thought to be the first deaths linked to the current outbreak outside Africa.

Spanish authorities would not give the specific cause of death for the fatalities pending the outcome of an autopsy, while Brazilian authorities underlined that the man who died had “other serious conditions”.

“The usual reasons patients might require hospital care include help in managing pain, secondary infections, and in a small number of cases the need to manage life-threatening complications such as encephalitis,” Smallwood explained.

According to the WHO, more than 18,000 cases have been detected throughout the world outside of Africa since the beginning of May, with the majority of them in Europe.

The WHO last week declared the monkeypox outbreak a global health emergency.

As cases surge globally, the WHO on Wednesday called on the group currently most affected by the virus – men who have sex with men – to limit their sexual partners.

Early signs of the disease include a high fever, swollen lymph glands and a chickenpox-like rash. The disease usually heals by itself after two to three weeks, sometimes taking a month.

A smallpox vaccine from Danish drug maker Bavarian Nordic, marketed under the name Jynneos in the United States and Imvanex in Europe, has also been found to protect against monkeypox.