Egypt’s state news agency says 21 more people have died due to a scorching heat wave, raising this week’s death toll to more than 60.

The official MENA news agency said Wednesday that the latest deaths are from the previous day, mostly elderly people. It says 581 people are in hospital for heat exhaustion.

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The Mideast has been hit by a heat wave since late July. Egyptian summers are usually hot, but temperatures this week soared to 46 degrees Celsius (114 degrees Fahrenheit) in the south.

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At least 40 people had died on Sunday and Monday, including detainees and patients in a psychiatric hospital, according to officials. It wasn’t immediately clear whether Tuesday’s death toll includes a German national living in the southern city of Luxor who died from heatstroke.

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