Mexico and Cuba reported the deaths of two people who had tested positive for monkeypox, although neither country directly attributed the deaths to the viral disease.
The reports follow monkeypox-related deaths reported in Brazil and Ecuador last month, though such cases remain extremely rare in the current outbreak.
The Pan American Health Organization has reported at least 21,200 confirmed cases of monkeypox in the Americas, and more than 80 countries around the world have reported new cases of the disease, which is endemic in parts of Africa.
Mexico’s health ministry said on Tuesday that experts were investigating the death of an HIV-positive patient who had died of septic shock and pneumonia after testing positive for monkeypox.
Mexico has reported 386 confirmed and 862 probable cases of monkeypox infection.
Cuban authorities said a 50-year-old Italian man died Sunday after being diagnosed with monkeypox on Saturday.
The Public Health Ministry said the tourist, who had arrived on August 15, had been in an unstable condition since Thursday and deteriorated rapidly.
The ministry pointed to an autopsy report that said the cause of death was sepsis related to pneumonia and organ damage.
The World Health Organization has warned that people with underlying immunodeficiencies could be at risk of more severe symptoms and death after contracting monkeypox. Nearly 42,000 monkeypox infections have been reported worldwide since May.
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