Seven cases of monkeypox have been confirmed in London and northeastern England, one of which was linked to travel outside of the country, health officials said. According to the U.K. Health Security Agency, current evidence suggests that the rare disease may be spreading in the local community.

The U.S. health officials warned on Tuesday that the spread of the disease could affect people in other countries. On Wednesday, two more European countries announced suspected and confirmed cases of the disease. There are more than a dozen probable cases that have been identified in Portugal and eight potential cases in Spain.

According to the CDC, monkeypox is a rare disease caused by a poxviruses that is related to the variola virus. The initial symptoms of the infection include a high temperature, headaches, fatigue, and a swollen lystium, as well as a rash on the face and on the body, eventually giving rise to blisters, blisters, and raised bumps on the skin. In Africa, where the disease is endemic, it can be fatal in 10% of cases, but in the majority of cases, the illness is mild and resolves in about two to four weeks.

According to the CDC, monkeypox has been linked to international travel and animal imports. African rodents and non-human primate can carry the virus. The source of the six non-travel-related infections in the U.K. remains a mystery.

There have been 20 of the worst epidemics in history.

This is rare and unusual, according to the statement released Monday.

According to the CDC, the monkeypox virus can enter the body through contact with broken skin, the respiratory tract or the eyes, nose or mouth. Drop of spit and mucus is thought to be the most common way of transmission between people.

Respiratory droplets cannot travel more than a few feet, so long face-to-face contact is required for transmission to occur, the CDC said. People can pick up the virus from contaminated objects, such as clothing and linens, or from bodily fluids with broken skin.

On May 7, the UKHSA reported a case of monkeypox that was linked to travel, and that person picked up the disease while in Nigeria. The National Health Service worked with the UKHSA to notify people who might have been in close contact with the person who had the disease.

The UKHSA identified two people in a London household who had also contracted monkeypox, but they were not related to the initial travel-related case. On May 16, the agency announced four more monkeypox cases that had no known connection to the previous cases.

The latest 4 cases are all men who have sex with men.

The general public has a low risk of contracting the virus, as the pathogen requires close contact to spread, according to the UKHSA statement. Men who are gay and bisexual are urged to contact a sexual health service without delay.

According to the Spanish news outlet El País, eight suspected cases in Spain were flagged at a clinic that treats sexually transmitted diseases.

As the U.K. launched its investigation into the nation's monkeypox cases, CDC officials raised concerns that there may be multiple chains of transmission rippling through the country, only some of which have been detected.

There are two clusters that have no link to travel or to other people who are associated with an outbreak. It suggests that there are unknown chains of transmission, according to a senior CDC official.

The CDC may issue an alert to health care facilities and clinics that treat sexually transmitted diseases to be on the lookout for potential monkeypox cases, according to McQuiston.

It was originally published on Live Science.