Countries have reported the first monkeypox deaths outside of Africa in the current outbreak. Authorities in Europe are expecting more deaths and urging efforts to stop the spread of the disease.

Brazil and Spain logged one monkeypox death each on July 29, AP News reported. Spain then reported its second monkeypox-related death on July 30.

The deaths in Spain are believed to be the first ones related to monkeypox in Europe amid the current outbreak in countries that haven't historically reported the disease, according to the outlet. Although authorities in both Spain and Brazil are still investigating whether monkeypox really caused the deaths, with the patient in Brazil reportedly also having suffered from "other serious conditions," authorities in Europe are expecting more reports of monkeypox deaths.

"With the continued spread of monkeypox in Europe, we will expect to see more deaths," Catherine Smallwood, a senior emergency officer at World Health Organization (WHO) Europe said, as per the outlet. "Our goal needs to be on interrupting transmission quickly in Europe and stopping this outbreak."

As of the WHO's July 28 update, the European Region remains to be the hardest hit region in this outbreak, comprising over 67.9% of the cases in the past four weeks. The Americas follow behind with 30% of the cases.

The deaths came just a week after the WHO declared monkeypox a global health emergency. Smallwood said the deaths don't change their "assessment of the outbreak in Europe," noting that the disease, in general, "heals itself" even without treatment.

"We know that although the disease is self-limiting in most cases, monkeypox can cause severe complications," she added.

In India, for instance, a 22-year-old man's death in Kerala on July 30 is also suspected to be related to monkeypox, The Times of India reported.

As of July 29, there have been a total of 22,485 confirmed monkeypox cases during the 2022 outbreak, according to data from the U.S. Centers for Disease Control and Prevention (CDC). Out of these cases, only 344 were reported from the countries that have historically reported monkeypox. The remaining 22,141 were in countries that don't usually report cases of the disease.

In the U.S., cases continue to be reported in many states, with San Francisco and New York City already declaring monkeypox a public health emergency. In New York City, more than 1,000 have tested positive for orthopoxvirus/monkeypox as of July 29, and authorities noted that "many more" have likely been undiagnosed. San Francisco, on the other hand, logged 305 cases out of California's more than 700 cases as of July 29.

The declarations, authorities say, will help strengthen the responses to the monkeypox cases.

"We know that this virus impacts everyone equally — but we also know that those in our LGBTQ+ community are at greater risk right now," San Francisco Mayor London Breed said in the news release about the declaration. "Many people in our LGBTQ+ community are scared and frustrated. This local emergency will allow us to continue to support our most at-risk, while also better preparing for what's to come."