Brazil on Friday reported the first monkeypox-related death outside the African continent in the current outbreak, shortly before Spain confirmed Europe's first known death in the outbreak later in the day.
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, adding the patient was hospitalised in the southeastern city of Belo Horizonte and died from septic shock after being taken to the intensive care unit.
The first monkeypox death in the Americas came less than a week after the World Health Organization (WHO) declared the rapidly spreading outbreak a global health emergency, its highest level of alert.
In Spain, authorities did not immediately release details of the person who died from monkeypox.
WHO had so far reported only five confirmed monkeypox deaths, all in Africa.
Brazil, along with the US and Canada, is among the countries most affected by monkeypox in the Americas, where more than 5,000 cases have been reported to date, according to the Pan American Health Organization (Paho).
The South American country reported 1,066 confirmed cases and 513 suspected cases of the disease, the vast majority (744) in Sao Paulo state, the health ministry said.
More than 98% of the confirmed cases in the country are men who have sex with men, with an average age of 33 years, according to ministry data.
Paho said in a press briefing this week that almost all cases had been reported among men who have sex with men between the ages of 25 and 45, but warned that anyone can get the disease regardless of their gender or sexual orientation.