(BIVN) – A Big Island resident with a history of travel to the mainland is one of the two latest identified cases of monkeypox in Hawaiʻi, brings the statewide total number of cases to eight.

The Hawaiʻi Department of Health says the second newly reported case is an Oʻahu resident. Connections to previously reported cases are under investigation, officials say.

“The risk to most Hawaiʻi residents remains low, but with the number of cases growing across the country, we expect to identify more cases in Hawaiʻi,” said Deputy State Epidemiologist Dr. Nathan Tan in a news release. “We understand a fair amount about how monkeypox spreads—primarily through close, intimate contact. DOH continues to conduct case investigation, coordinate vaccination and treatment, and work with healthcare providers across the state.”

From the Department of Health:

DOH continues to conduct contact tracing and coordinate vaccination and treatment, which can be effective in managing monkeypox infections. At this time, DOH is using Hawaiʻi’s limited vaccine allocation to vaccinate close contacts of people known to have monkeypox, and for people who may have had high-risk exposures in venues or areas where monkeypox is actively spreading. DOH is arranging statewide vaccine distribution and administration. Vaccines are not available through healthcare providers at this time.

While most people diagnosed with monkeypox experience mild to moderate illness, the rash and sores can be itchy and painful. Infection begins with flu-like symptoms such as fever, headache, muscle aches, chills, exhaustion, and swollen lymph nodes. Infection progresses to a rash or sores, often on the hands, feet, chest, face, or genitals. Individuals generally become ill within 21 days of exposure.

Monkeypox is mainly spread through close, intimate contact with body fluids, lesion material, or items used by someone with monkeypox. Monkeypox may be spread through large respiratory droplets. These droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required.

Individuals with monkeypox symptoms, including flu-like symptoms, swollen lymph nodes, or new or unexplained rash or sores, should immediately contact their healthcare provider.

Nationwide, the current cases are primarily spreading among social networks of gay, bisexual, and other men who have sex with men. In Hawaiʻi, at least some of the cases have been reported among gay or bisexual men. However, anyone who has close contact with someone with monkeypox is at risk of infection, regardless of sexual orientation or gender identity.