Another 36 cases of monkeypox have been detected in England, health officials have announced.
The latest cases bring the total number of monkeypox infections confirmed in England since May 7 to 56, the The UK Health Security Agency (UKHSA) revealed on Monday.
The UKHSA released updated figures on the situation after Scotland confirmed its first case. As of Sunday, there were 20 cases.
Cases of monkeypox have been reported in 14 countries, according to epidemiologists at Harvard University who are tracking the spread, including 40 cases in Spain and 23 in Portugal.
Monkeypox is usually found in West Africa, and the virus does not often spread elsewhere.
Transmission between people is occurring in the UK, with a large proportion of cases identified in the gay, bisexual and men who have sex with other men community.
Monkeypox is not normally a sexually-transmitted infection, but it can be passed on by direct contact during sex.
It can also be spread through touching clothing, bedding or towels used by someone with the monkeypox rash, and through the coughs and sneezes of somebody with the infection.
Earlier on Monday Prime Minister Boris Johnson said monkeypox is a rare disease but it is important to “keep an eye on it”.
He told reporters on a visit to a school in south-east London: “It’s basically a very rare disease and so far the consequences don’t seem to be very serious, but it’s important that we keep an eye on it and that’s exactly what the the new UK Health Security Agency is doing.”
Asked whether there should be quarantine for visitors or the use of the smallpox vaccine, Mr Johnson said: “As things stand the judgment is that it’s rare.
“I think we’re looking very carefully at the circumstances of transmission. It hasn’t yet proved fatal in any case that we know of, certainly not in this country.”
The Government has stocks of the smallpox vaccine, which is being offered to very close contacts of those who have been affected.
Those at the highest risk of contracting the disease are being asked to self-isolate at home for 21 days, with others warned to be on the lookout for symptoms.
The disease is usually mild but can cause severe illness in some cases.
Symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.