The Hawaii Department of Health this afternoon announced the second “probable case” of monkeypox identified in a Hawaii resident.

Health officials said the individual is an Oahu resident who came into close contact with the first probable case of another Oahu resident who was hospitalized at Tripler Army Medical Center. State health officials on June 3 reported the first probable case of an individual who had symptoms consistent with monkeypox and recently traveled to an area with confirmed cases.

The state Laboratories Division detected the orthopoxvirus strain of monkeypox through testing of skin lesion specimens from the first resident.

Testing to confirm both cases is pending with the U.S. Centers for Disease Control and Prevention. DOH said it has no timeline for when that will be. Contacts have been identified and are being monitored.

“While the risk for most Hawaii residents remains low, we urge individuals with symptoms consistent with monkeypox to contact their healthcare provider,” said Deputy State Epidemiologist Dr. Nathan Tan in a news release. “We continue to work closely with providers, federal agencies, and the community as we respond to these cases.”

Health officials describe monkeypox as a rare disease caused by the monkeypox virus.

Infection begins with flu-like symptoms such as exhaustion, fever, headaches, chills, muscle aches and swollen lymph nodes. It then progresses to a rash or sores, often on the hands, feet, chest, face, or genitals, they said, adding that patients generally become ill within 21 days of exposure.

A person is considered infectious from the onset of symptoms, officials said, and is presumed to remain so until lesions have crusted, crusts have separated, and a fresh layer of healthy skin formed underneath.

Monkeypox can spread through close, prolonged contact with an infected person or animal. This includes direct contact with body fluids, lesions, or items used by someone with monkeypox such as bedding.

The state Department of Health said on June 3 that the disease is not sexually transmitted, however noted that the CDC has reported that many cases have been among gay, bisexual, and other men who have sex with men or those who recently traveled abroad or to the continental United States.

Monkeypox can also be spread through large respiratory droplets. These droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required, according to the health department.

According to the World Health Organization, monkeypox is commonly found in central and west Africa, where there are tropical rainforests, and where animals that may carry the virus typically live, but it has been increasing in urban areas.

CDC is currently tracking multiple cases of monkeypox reported in several countries that do not normally report monkeypox, including the U.S. So far, CDC has confirmed monkeypox and orthopoxvirus cases in 15 states, including Washington, California, Utah, Arizona, Texas, New York, and Florida.

Health officials said those with symptoms consistent with monkeypox infection should immediately contact their health care provider, which should immediately report any suspected cases to the state Department of Health.

“Providers should be alert for patients who have rash illnesses consistent with monkeypox, especially in those with a recent travel history to areas reporting monkeypox cases and regardless of gender or sexual orientation,” according to the news release.

This story has been updated to reflect that the state Department of Health said on June 3 that monkeypox is not sexually transmitted, but noted that the CDC has reported many cases have been among gay or bisexual men.