WASHINGTON (REUTERS) - The United States on Thursday (May 26) said it had identified nine monkeypox cases in seven states, some in individuals who did not have a recent history of international travel.

As of Wednesday, the nine cases were confirmed in Massachusetts, Florida, Utah, Washington, California, Virginia and New York, the US Centres for Diseases Control and Prevention (CDC) told reporters.

Most of the infections detected globally so far have not been severe. Many, but not all, have been reported in men who have sex with men. Symptoms include fever and a distinctive bumpy rash.

All of the US cases "are within gay, bisexual men and other men who have sex with men," CDC director Dr Rochelle Walensky said in a news briefing.

Dr Walensky urged an approach that is "guided by science, not by stigma."

Over 20 countries where monkeypox is not endemic have reported outbreaks of the viral disease, with about 200 confirmed and more than 100 suspected cases of infections, mostly in Europe.

The World Health Organisation urged countries to increase surveillance for monkeypox.

The first monkeypox case in the United States was reported in Massachusetts last week.

Some of the nine cases identified as of Wednesday have a recent history of international travel to areas with active monkeypox outbreaks but "others do not", the CDC director said on Thursday.

The disease, which mostly occurs in west and central Africa, is a viral infection that was first recorded in the Democratic Republic of Congo in the 1970s.

"We shouldn't be surprised to see more cases reported in the US in the upcoming days," Dr Raj Panjabi, White House senior director for health security and biodefence, said in the press briefing.