Officials from the New York Department of Health have confirmed the state’s first known case of monkeypox in a person under 18.

The virus was detected in a child or teenager living outside of New York City, according to a new report on the outbreak. No other information about the case has been released.

Children in other states, including Texas, California, Florida, Oregon, and Maine, have also contracted monkeypox, which is primarily spread through skin-to-skin contact.

While the virus has overwhelmingly affected gay and bisexual men, monkeypox has now been detected in two women living outside the city, and there have been at least 16 positive cases among women living in the city as well. In addition, NBC New York reports another 48 transgender or nonbinary people have tested for monkeypox in NYC, as well as 14 people with unknown gender identities.

New York continues to lead the nation in monkeypox cases with 2,798 confirmed infections as of August 19th, according to state-compiled data. The vast majority of those — 2,596 cases — have been reported in New York City. According to NYC's Department of Health, over 1,104 cases have been reported in Manhattan alone.

Although the school year is set to start in a few weeks, Curbed reports that New York City schools have not received any official guidance about monkeypox as of yet. Cadence Acquaviva, a spokesperson for the New York State Department of Health, told Curbed that the department will “soon issue back-to-school information for K-12 schools as it relates to monkeypox, which will align with the CDC.”

On July 30th, the Centers for Disease Control and Prevention released guidance to health care advisers on clinical considerations for children and adolescents with symptoms.

Earlier this month, officials announced that city-run COVID-19 vaccination sites for toddlers would be closed in order to pivot to monkeypox vaccine administration.

Officials identified New York City’s first case of monkeypox back in May and declared the outbreak a public health emergency at the end of July.