NEW YORK (PIX11) — New York identified its first case of monkeypox in a juvenile victim, officials with the Department of Health said on Thursday.

Officials have not said much about the case. The patient is under the age of 18 and the case is outside of New York City, which has been considered the epicenter of the monkeypox outbreak. Lenox hill Pulmonologist Dr. Len Horovitz was not surprised by the latest development.

“Probably the juvenile was in contact with a caregiver or some household contact who had monkeypox,” Horovitz said.

A number of children in the United States have been diagnosed with monkeypox. Two children each in Indiana and California were diagnosed, along with a child visiting Washington, D.C., from out of the country.

As of Friday, nearly 2,600 cases of monkeypox had been identified in New York City. There have been around 200 cases reported in the state outside of New York City.

Monkeypox is usually spread through direct contact with the rash or sores of someone who has the virus. It can also spread through contact with clothing, bedding, and other items used by a person with monkeypox, or from respiratory droplets that can be passed through prolonged face-to-face contact.