"Unfortunately 20 people had their (anthrax) diagnosis confirmed," a spokeswoman for the Yamalo-Nenetsky regional authorities told RIA Novosti news agency.
In addition, a 12-year-old boy died in hospital yesterday.
The number of those hospitalised on suspicion of infection rose to 90 people, 45 of them children, regional officials said.
It is the first outbreak of anthrax since 1941 in the region, which lies some 2,000 kilometres (1,250 miles) northeast of Moscow.
It came after a month of temperatures soaring up to 35 degrees Celsius (95 degrees Fahrenheit) that melted upper layers of permafrost, or permanently frozen soil, and sparked wildfires.
Anthrax is spread through a bacterium that is encased in a tough, rod-shaped shell.
The spores exist naturally in the soil and commonly infect livestock which ingest or inhale them while grazing.
Humans can become infected from contact through breathing in the spores, eating contaminated food or through cuts in the skin, for instance by handling diseased animals.
The governor's spokeswoman Natalya Khlopunova said those infected included a family that "ate reindeer meat raw and drank the blood," saying "the nomads do have this custom."
The authorities appealed for calm, stressing there was "no epidemic" and the infected area had been sealed off.
The defence ministry said it has sent in more than 200 specialist troops with helicopters and drones to decontaminate the infected zone and burn corpses of infected animals.
The regional authorities said that more than 160 nomadic herders had been evacuated from the contaminated zone, where more than 2,300 reindeer have died.
Around 16,500 people in the region still lead a traditional nomadic way of life, hunting, fishing and herding reindeer.
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