The Centers for Disease Control and Prevention expressed concern Tuesday about an unusual outbreak of monkeypox in the United Kingdom, suggesting there appears to be at least some undetected transmission of the virus there and warning of the possibility that the outbreak could spread beyond U.K. borders.

“We do have a level of concern that this is very different than what we typically think of from monkeypox. And I think we have some concern that there could be spread outside the U.K associated with this,” Jennifer McQuiston, a senior CDC official, told STAT in an interview.

Seven confirmed and one probable case of monkeypox have been discovered in the U.K. since early May — an unusually large number given that human monkeypox cases are uncommon, and are especially rare outside West and Central Africa. While one of the cases had recently traveled to Nigeria, where monkeypox is endemic, the others appear to have contracted the virus in the U.K. None of the people infected domestically has any known connections with the traveler and the timing of the onset of the cases suggest he was not the source of those infections.

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