It’s a surprising outbreak of disease that rarely appears outside Africa.

Health officials around the world are keeping watch for more cases because, for the first time, the disease appears to be spreading among people who didn’t travel to Africa.

HOW MANY MONKEYPOX CASES ARE THERE TYPICALLY?

Patchy health monitoring systems mean many infected people are likely missed, experts say.

Isolated cases of monkeypox are occasionally spotted outside Africa, including in the U.S.

The cases are typically associated with travel to Africa or contact with animals from areas where the disease is more common.

It’s the first time monkeypox appears to be spreading among people who didn’t travel to Africa.

Britain’s Health Security Agency said its cases are not all connected, suggesting that there are multiple chains of transmission happening.

cases “do not necessarily imply any recent change in the virus’ route of transmission,” Balloux said.