India has confirmed its first death caused by monkeypox in the southern state of Kerala.
A 22-year-old man, who had recently traveled to the state from the United Arab Emirates, died on Saturday.
Kerala Health Minister Veena George said the man had initially tested positive for the virus abroad. Samples tested after his death also detected the virus, she said on Monday.
This is the fourth monkeypox death reported globally, outside of Africa.
Twenty close contacts of the man have been categorized as "high risk" and isolated, the minister told reporters.
These include his friends, family and nine people he recently played football with.
The illness is caused by the monkeypox virus, a member of the same family of viruses as smallpox, although it is much less severe and experts say chances of infection are low.
The World Health Organization (WHO) declared the monkeypox outbreak a global health emergency last month.
Following the man's death in Kerala, the state government formed a high-level committee to look into his medical reports, Ms George said.
The young man had developed fever and had swollen lymph nodes when he was admitted to a private hospital on 27 July, Ms George told the news website The NewsMinute on Sunday.
He, however, had no rashes on his body and the doctors saw no reason to suspect that he had monkeypox, she said.
The man had tested positive for the virus in the UAE on 19 July, days before he left for Kerala, but his family informed health officials only on 30 July, the minister said on Monday.
His condition, however, quickly deteriorated in the hospital and he was on ventilator support before he died, she added.
His samples were sent to the National Institute of Virology which confirmed monkeypox on Monday, she said.
Authorities will now investigate why the man had delayed seeking medical help.
Passengers who were on the flight with him from UAE to Kerala have been alerted about the situation. There is, however, no cause for concern yet since they were not in close contact with him, Ms George said.
India has reported four cases of monkeypox so far - three in Kerala and one in the capital, Delhi.
The first patient, who had tested positive on 14 July, was treated in Kerala's capital, Thiruvananthapuram (formerly Trivandrum).
He later recovered and was discharged from the hospital, Ms George said on Saturday.