WASHINGTON, D.C. — The U.S. Centers for Diseases Control and Prevention (CDC) said it has identified nine monkeypox cases in seven states across the country as of Wednesday.

Symptoms include fever and a distinctive bumpy rash.

Cases were confirmed in Massachusetts, Florida, Utah, Washington, California, Virginia and New York. As of Thursday evening, Michigan has had no cases of the virus.

More than 200 confirmed or suspected infections of the viral disease have been reported in 20 countries, mostly in Europe.

Thankfully, a majority of the cases of the disease reported globally do not appear to be severe.

The first monkeypox case in the U.S. was reported in Massachusetts last week.

The disease, which mostly occurs in west and central Africa, is a viral infection that was first recorded in the Democratic Republic of Congo in the 1970s.

The CDC has provided guidelines to keep oneself and loved ones protected against the virus.

People who may have symptoms of monkeypox should contact their healthcare provider. This includes anyone who traveled to Central or West African countries, parts of Europe where monkeypox cases have been reported or other areas with confirmed cases of monkeypox during the month before their symptoms began.

Those who have reported contact with a person with confirmed or suspected monkeypox, or men who regularly have close or intimate contact with other men, including those who meet partners through an online website, digital application (“app”) or at a bar or party, are also advised to speak to a healthcare professional, according to the CDC.

Monkeypox has an incubation period which lasts on average 7-14 days. The disease has a set of initial symptoms like fever, malaise, headache, weakness and more, which lead into full development of symptoms. A rash appears after the initial period, with lesions typically begin to develop simultaneously and evolving together on any given part of the body, including the mouth.

A person is contagious from the onset of the rash through the scab stage.

The severity of illness can depend upon the initial health of the individual, the route of exposure and the strain of the infecting virus.

A feature that distinguishes infection with monkeypox from that of smallpox is the development of swollen lymph nodes. Swelling of the lymph nodes may occur in many different locations on the body or can be localized to several areas like the neck and armpit.