On 6 October, a 61-year-old man died at Hospital de Donostia after more than a month in hospital. Whether mpox directly caused his death remains unresolved. He was being treated for throat cancer and was immunosuppressed. The Basque Department of Health said it could not confirm a direct causal link, although the likelihood of one is considered high. Doctors stressed that he died “with mpox”, not necessarily “from mpox”.
More than 30 people linked to the hospital room have been vaccinated and placed under follow-up. They include healthcare workers and people in the patients’ circles who were considered at risk. The deceased man was reportedly vaccinated as well. Osakidetza tracked about 50 potential contacts linked to the hospital exposure, a wider group than the roughly 30 people who received vaccination.
The suspected route of transmission remains uncertain.
The man entered the hospital on 1 September because of a throat tumour. After surgery, he suffered bleeding that required two further operations. His family said his recovery initially looked positive. He had started rehabilitation in the hospital gym and was expected to begin speech therapy in October. His serious underlying illness and severely weakened condition were impressive factors in assessing the infection’s possible consequences.
The possible exposure took place after he shared a room for less than a week with another patient identified as the index case. That patient had also been admitted because of a throat complication. Hospital sources said he initially had no characteristic skin lesions associated with monkeypox, although he did have an infectious condition. Miguel Ángel Goenaga, head of infectious diseases at Hospital de Donostia, said mpox generally has low mortality, but its effects can be far more serious in people with major underlying illnesses and severely reduced immunity.
Information from the family, masks began appearing among staff after the two patients had several days of ordinary contact. Staff later told the family that the roommate had tested positive during a routine examination and had been discharged to isolate at home. The hospital then identified people who might have been exposed and put the required measures in place. Osakidetza followed about 50 potential contacts, including medical workers and people in the patients’ circles. Authorities consider new linked cases very unlikely after the preventive measures.
After the patients were separated, the 61-year-old developed further bleeding or an infection linked to the throat operation. Two or three days after severe headaches began, spots appeared on his forehead. Lesions were also seen on his palms. An infectious diseases doctor and an internist assessed him before he was isolated in the infectious diseases unit.
Doctors later returned him to the other ward because treating the throat problem was considered more urgent. His condition then worsened, and he was transferred to intensive care. Family members said he did not recover despite antibiotics. He also received antiviral medication and morphine.
Miguel Ángel Goenaga, head of infectious diseases at Hospital de Donostia, did not identify a precise transmission mechanism when speaking to the media. He said infection generally requires close contact and that transmission in hospitals is uncommon. Possible explanations included contact between the patients at night. An exchanged object was another possibility.
Other routes were considered less impressive in this setting. One was prolonged face-to-face contact through respiratory secretions. Direct contact with contaminated objects was another. Transmission through the placenta from a pregnant mother to a fetus was also considered less impressive.
The case comes as infections rise again in Euskadi. The region recorded 245 cases in 2022, followed by one diagnosis in 2023 and 12 in 2024. Six people were diagnosed in 2025. The first nine months of 2026 produced 35 cases, including eight in Gipuzkoa. Figures from Euskadi’s health authorities show a marked increase in detection during 2026, though the reports do not explain why. Two other people have died from monkeypox in Spain this year.
Monkeypox is caused by the monkeypox virus and usually spreads through close physical contact, not brief exposure in a shared space. Common symptoms include fever and headache. Muscle pain and back pain are also reported. Swollen lymph nodes and chills are symptoms; exhaustion is another. A rash can spread from the face to other parts of the body. The illness generally lasts two to four weeks, and most patients recover.
The family’s account describes a complicated hospital course but does not establish that monkeypox directly caused the death. The patient had a serious cancer diagnosis and underwent repeated surgery before the infection was identified. The Basque Department of Health and Osakidetza continue to assess the cause of death; the exact transmission mechanism remains unknown as well. This case is distinct from the earlier Madrid investigation covered in a separate report. Euskadi has recorded its first death involving monkeypox, but the infection’s exact role remains unproven.
