BOSTON (AP) — The Massachusetts Department of Public Health on Sunday reported two more cases of monkeypox in the state.

The two men who contracted monkeypox had close contact with each other, and are not believed to be linked to the state’s first case of monkeypox last month, officials said.

Monkeypox typically spreads by skin-to-skin contact, or contact with contaminated clothing or bedding. Most patients suffer fever, body aches, chills and fatigue. Others might develop a rash and lesions.

The disease is rarely fatal but health officials are keeping a close eye on it. The latest monkeypox patients are currently isolating themselves.

“It is very important to be aware of the symptoms of monkeypox and to be vigilant. Individuals with concerning rashes should contact their healthcare provider,” said Dr. Catherine Brown, state epidemiologist.

The latest U.S. data indicates there have been nearly 50 cases of monkeypox, including the first case in Massachusetts on May 18.