Monkeypox: Brazil, Spain report first deaths outside Africa

Brazil reported the first monkeypox-related death outside the African continent on Friday, and Spain later confirmed the first known deaths in Europe.

The current outbreak began in May, with 20 cases reported in the UK. Since then, it has grown to more than 20,000 cases in 78 countries.

Last Saturday, the World Health Organization (WHO) declared the monkeypox outbreak a “public health emergency of international concern,” its highest threat level.

It has been endemic in West and Central African countries for decades, but 70% of current infections are in Europe and 25% in the Americas.

What do we know about fatalities?

According to the Minas Gerais state health ministry, the Brazilian victim was a 41-year-old man who also suffered from lymphoma and a weakened immune system.

“Comorbidities aggravated his condition,” the ministry said.

He died of septic shock after being transferred to the intensive care unit.

The first death in Spain was recorded on Friday in the Valencian Community, the second was recorded on Saturday in the southern province of Andalusia. Both victims had been hospitalized with infections that attacked the brain in the days before their deaths. Deaths may be related to pre-existing conditions.

Spain is one of the most affected countries in the world and 4,298 people have been infected by the virus, according to the emergency and alert coordination center of the Spanish Ministry of Health.

“Of the 3,750 [monkeypox] patients with available information, 120 cases were hospitalized [3.2%]and one case has died,” the center said.

The WHO said about 8% of monkeypox cases in Europe have required hospitalisation. The World Health Organization has so far reported five confirmed deaths from monkeypox in African countries.

New WHO advice on monkeypox

WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday that 98% of monkeypox cases had been identified in men who have sex with men.

He urged them to limit their number of sexual partners as cases of monkeypox increase in their community and to exchange contact details with any new partners.

“This is an outbreak that can be stopped… The best way to do that is to reduce the risk of exposure,” Tedros told a news conference from Geneva. “That means making safe choices for yourself and others.”

Vaccines are available to help protect against the virus, but there is a limited supply. Monkeypox is not as contagious or deadly as smallpox. The WHO says the type of smallpox currently spreading outside of Africa has a fatality rate of about 1%. Symptoms of monkeypox infection include fever, muscle pain, and a blistering rash.

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