India has confirmed its first case of a deadlier strain of mpox, which has raised alarm among health officials around the world over the rapid pace of its spread.

The clade Ib strain of the virus was confirmed by health authorities in the southern state of Kerala after being detected last week in a 38-year-old man who had recently traveled to Dubai.

On Wednesday, the state’s Health Minister Veena George hailed Kerala’s “robust health care system” for detecting the case.

The outbreak of the strain, which had previously been contained to the Democratic Republic of Congo, was declared a global health emergency by the World Health Organization (WHO) last month after it spread to four previously unaffected African countries.

The strain has since been detected in several countries outside Africa, including Sweden and Thailand.

Mpox, formerly known as monkeypox, is a viral disease that can spread easily between people and from infected animals. It can spread through close contact such as touching, kissing or sex, as well as through contaminated materials like sheets, clothing and needles, according to WHO.

Symptoms include fever, rash, lesions, headache, muscle and back pain, low energy and enlarged lymph nodes.

The virus is characterized by two genetic clades, I and II. A clade is a broad grouping of viruses that has evolved over decades.

Clade II was responsible for a global outbreak that WHO also declared a global health emergency from July 2022 to May 2023. Clade Ib causes more severe disease.

According to Dr. Shubhin C, a health official in Kerala’s Mallapuram district, the infected patient is being tested every four days as he recovers in isolation in a local hospital.

Authorities had identified 29 people who came into contact with the patient and they are now in self-quarantine, he said.

Some 37 passengers on the flight from Dubai to Kerala and five other close contacts of the patient are being monitored, he added.

Health authorities in Kerala are well-versed in grappling with infectious diseases.

“Surveillance has been strengthened, including at airports,” said George, the health minister, adding there are five mpox testing facilities with more to be set up if required. Isolation facilities have also been established, he said.

Last year, the state contained an outbreak of the Nipah virus after two people died. It shut schools and tested hundreds of people to prevent the spread of the rare and often deadly disease.