Health experts say monkeypox cases in New York City are rising, but faster diagnosis processes could help counter the spread.

Manhattan Borough President Mark Levine co-hosted an online panel on Monday with other elected officials and health experts geared towards walking the public through where the city stands in its fight against the illness. Experts said that New York City was reporting 10 cases of monkeypox as of Monday.

While many of the early cases reported in recent weeks involved people traveling internationally, one expert said that was no longer a factor in the newest cases.

“Most of the recent cases, they reported no prior travel or exposure to somebody who’s traveled,” said Columbia University epidemiologist Dr. Wafaa El-Sadr. “So this means people have to be quite vigilant.”

By the latest statistics, El-Sadr said, there were 65 total cases in the United States so far, across 18 states in total. New York City had recorded more cases on its own than every state in the country except for California.

Monkeypox is characterized by lesions throughout the body, but El-Sadr said its important for people to pay attention to be attuned to other symptoms that can predate the onset of a rash. Those symptoms include swollen lymph glands, chills, fever, and fatigue.

It was unclear how people have been exposed to monkeypox, experts said, as those with mild symptoms may not be aware they have the virus. Initial cases were amongst gay or bisexual men, doctors said, though anyone can contract the disease through close contact with someone who has an active lesions, or contaminated materials.

“It's not considered to be a sexually transmitted infection as of yet, in a typical sense of the word,” El-Sadr said. “But of course, because sexual contact involves intimate and skin-to-skin contact, it's like it's possible to be transmitted during sex.”

Epidemiologist Dr. Jay Varma sat on the panel and said that the mild symptoms, combined with the location of the rashes in patients, could sometimes make it hard to detect. He also said that diagnosing the virus more quickly would help health experts with contact tracing and knowing where to administer available vaccines.

“People get symptoms, they may finally get sick, they go to one provider who thinks they may have chickenpox or herpes, and then they finally get diagnosed with with monkeypox,” Varma said. “By the time that happens, it's a bit too late to vaccinate your contacts and even your contacts of contacts. So that's the challenge that we're running into.”

HIV/AIDS researcher and activist Mark Harrington raised concerns about the stigmatization of the disease, and called for better data and faster testing for the disease.

“It concerns me that we don't have local labs that are able to test rapidly for this,” Harrington said. “Having the [Centers for Disease Control and Prevention] have a monopoly on testing and treatment, and vaccine supply is not good.”

El-Sadr echoed concerns about the pace of testing.

“I do think having rapid diagnostic capability is very, very vital, in order for us to catch as many cases as possible to be able to do the right thing, and also to be able to handle and manage the seek contacts also as quickly as possible,” El-Sadr said.

To help prevention efforts, Varma encouraged people planning on having intimate contact with others to keep track of their health by checking their temperature beforehand, and checking for any unusual bumps on their body.

“We're trying to really … balance between, you know, making sure that people have the information they need to protect their health, but also not generating a level of alarm that is, you know, disproportionate to the level of the problem,” he said.