SACRAMENTO, Calif. (KTXL) — Sacramento County health officials announced Thursday that four additional presumptive monkeypox cases have been identified. 

Health officials said all four cases are related to interstate travel and are unrelated to previously reported cases in the county. 

The four presumptive cases make it 14 total monkeypox cases in Sacramento County. Officials said contact tracing is ongoing and the risk to the general public remains low.

The four new presumptive cases were announced as the county is dealing with another 10 possible and confirmed cases.

According to the Centers for Disease Control and Prevention, there are 161 overall cases reported in the state of California as of July 13. 

Sacramento County’s first reported case of monkeypox was in late May, which was found to be a person who traveled back to the United States from Europe. 

A second case was reported days later by county health officials, who said that case was connected to the first and identified through contact tracing. 

On June 21, there were eight possible cases in Sacramento County and five of those cases were confirmed by the Centers for Disease Controls and Prevention. The three other cases were being tested at the time. 

Transmission of monkeypox occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus, officials said. 

According to officials, the virus enters the body in multiple ways:

  • Enters the body through broken skin (even if not visible)
  • Respiratory tract
  • Mucous Membranes (eyes, nose, or mouth) 

Symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes chills and exhaustion, health officials said. If someone is contracted the virus, a fever appears along with a rash developed within one to three days, according to officials.

Officials said the time from infection to symptoms for monkeypox is usually seven to 14 days, but can also range from five to 21 days. The illness from monkeypox can last from two to four weeks, officials said.