Spain reported its second monkeypox-related death on Saturday, in what is thought to be Europe’s second death from the disease in the current outbreak. Spain reported its first death on Friday, shortly after Brazil reported the first monkeypox-related death outside Africa in the current wave of the disease. According to a World Health Organization report from 22 July, only five deaths had been reported, all in Africa. The WHO last Saturday declared the rapidly spreading outbreak a global health emergency, its highest level of alert. In its latest report on Saturday, the Spanish health ministry said 4,298 cases had been confirmed in the country. Of the 3,750 patients for whom it had information, 120 or 3.2% had been hospitalised, and two had died, it said, without providing further details. The first death occurred in the north-eastern Valencia region and the cause was encephalitis, an inflammation of the brain associated with the infection, local media reported, quoting the regional health department. The Brazilian victim was a 41-year-old man who, according to the health ministry, also suffered from lymphoma and a weakened immune system. “The comorbidities aggravated his condition,” the ministry said. It added that the patient was hospitalised in the south-eastern city of Belo Horizonte and died from septic shock after being taken to intensive care.