(WWLP) – An outbreak of Monkey Pox has reached the United States with cases identified last week in Massachusetts and New York City.

This year, 160 cases of monkey pox have been reported in 16 countries, including 12 in Europe.

The disease is an ongoing issue in Africa, but rarely is detected outside of Democratic Republic of the Congo and Nigeria.

Person-to-person transmission is rare, but occurs through exchange of respiratory droplets or prolonged face to face exposure.

Symptoms begin with fever, headache, muscle aches and exhaustion followed by a rash. Illness typically lasts two to four weeks.

Infectious disease experts say the low case numbers remain a concern because many do not have a direct travel history to Africa, where the virus naturally circulates.