SIOUX FALLS, S.D. (AP) — South Dakota Health officials say a man from the eastern part of the state has contracted the state’s first assumed case of monkeypox, a disease that has emerged in more than 50 countries and 41 U.S. states.

The state public health lab identified the infection and forwarded the case to the Centers for Disease Control and Prevention for confirmation. Common symptoms include fever, fatigue, headaches, muscle aches, swollen lymph nodes, and a rash.

Some people in the current outbreak have only reported rashes, which typically are found on the hands, feet, face or genitals.