The World Health Organization (WHO) on Saturday said it is expecting more cases of monkeypox to emerge after a handful of infections were detected in the U.S. and Europe.

“The situation is evolving and WHO expects there will be more cases of monkeypox identified as surveillance expands in non-endemic countries,” the WHO said in a statement detailing the monkeypox outbreak.

Twelve WHO member states have reported cases of monkeypox since May 13, according to the agency. The infections, however, do not have established travel connections to endemic areas.

WHO said as many as five cases have been confirmed in the U.S. One infection was detected in Massachusetts in an individual who had recently returned to the U.S. from Canada.

Monkeypox is a rare disease that is commonly found in Africa. The recent diagnoses in the U.S., Europe and Canada are leaving scientists puzzled.

The WHO has record of 92 confirmed monkeypox cases and 28 suspected infections globally as of Saturday. The disease causes rashes, fever and swollen lymph nodes. The agency said information gives the impression that the virus is spread by physical contact with individuals who are symptomatic.

President Biden on Sunday said “everybody” should be concerned about the recent bubble of cases.

“They haven’t told me the level of exposure yet, but it is something that everybody should be concerned about,” Biden told reporters in Seoul, South Korea.

“We’re working on it hard to figure out what we do and what vaccine, if any, may be available for it,” he added.

He said the disease is “a concern in the sense that if it were to spread, it’s consequential,” but noted that his health advisers have not yet briefed him on the subject.

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