WASHINGTON (Reuters] – The U.S. Centers for Diseases Control and Prevention said Thursday it identified nine cases from monkeypox across seven U.S. States as of Wednesday.

According to the CDC, cases were confirmed in Massachusetts and Florida as well as Utah, Washington, California and Virginia.

The majority of infections found worldwide so far are not severe. Some of these infections have been seen in men who had sexual relations with women. The symptoms include a distinct bumpy rash and fever.

Reports from around 20 countries in which monkeypox has not become an epidemic have been made. There are more than 200 suspected or confirmed infections, most of them in Europe.

Massachusetts reported the first case of monkeypox in America last week.

This viral disease is most common in central and west Africa. It was first reported in the Democratic Republic of Congo during the 1970s.