U.S. health authorities announced yesterday that there are 21 cases of monkeypox in the country, and the disease, which has more than 700 cases worldwide, could spread locally.

Among the cases reported in the U.S., 20 were tracked in 11 states, and the first twenty -first infections were tracked and occurred abroad.

According to the Centers for Disease Control and Prevention, the nation’s leading federal health agency, most Americans ’infections are related to travel abroad.

But some of the other infections are associated with other known cases in the United States, and for one of those infected, the source of the infection has not yet been determined.

“A localized outbreak is possible,” warned Jennifer McCaston, who oversees the CDC’s response to monkeypox, adding: “We continue to believe that the risk to public health is minimal.”

So far, no disease -related deaths have been reported, either in the United States or abroad, McCaston said.

In addition, most of the injuries seen in the U.S. are among gays, but all are affected.

“We are working to prevent” the disease so that it does not become endemic, as it does in many African countries, McCaston said.

And he continued: “The US approach revolves around diagnosing cases and contacts, making sure they are offered a vaccine, and isolating those who are infected.”

There are two smallpox vaccines that can be used, and 100 million doses are available in the United States, and antiviral treatment is also available.

“We have enough vaccines to deal with the current outbreak,” said Don O’Connell, a U.S. Department of Health official.