The U.S. Centers for Disease Control and Prevention said this week that more than 200 people may have been exposed to monkeypox this month.

A person in Texas was confirmed to have monkeypox last week after contracting the illness in Nigeria and returning to the U.S. The CDC said Tuesday the people who may have been exposed are spread out in 27 states and potentially exposing others.

Andrea McCollum, head of the poxvirus epidemiology unit at the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, said the contact tracing would continue until the end of the month, including followups and health checks with those already identified and contacted.

According to the CDC, patient zero flew to Atlanta from Lagos, Nigeria, on July 9. The person took a flight to Dallas that same day and checked into a hospital in Dallas July 15.

Those who may have been exposed include passengers and crew on the Atlanta-Lagos flight, crews who cleaned both planes and family members of the individual. Passengers on the Atlanta-Dallas flight were deemed to not have been exposed long enough since the flight is much shorter than the transcontinental jaunt.

“We define indirect contact as being within 6 feet of the patient in the absence of an N-95 or any filtering respirator for greater than or equal to three hours,” McCollum said.

The CDC said the fatality rate for monkeypox is about 10% but causes a less severe illness than smallpox. Symptoms include fever, chills, swollen glands and a characteristic rash that spreads across the body, according to STAT News.

Cases in humans are still considered rare, but the incubation period can last up to 17 days. However, those who were exposed will likely start exhibiting symptoms of infection soon.

“We’re in the time frame where we certainly want to closely monitor people,” McCollum said.

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