Public health officials in Iowa’s largest county have confirmed the first case of monkeypox in Polk County.

According to a news release from the Polk County Health Department, the patient was likely infected during travel within the United States, is isolating and receiving outpatient care. Iowa’s first case of monkeypox was confirmed on July 1 in an adult from north central Iowa who was infected during international travels.

Public health officials say the virus does not spread easily and most who are contracting the virus in the U.S. have had inmate, sexual contact with someone who has the virus. People with direct close contact with a monkeypox patient are offered a vaccine series that can prevent symptoms or serious illness.

Monkeypox symptoms can first appear up to 21 days after an exposure. While some patients only develop a rash or lesions, others get enlarged lymph nodes and a fever in addition to a rash.