This 2003 electron microscope image shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. Credit: Cynthia S. Goldsmith and Russell Regner / CDC via AP

NEW YORK — Two new presumed monkeypox cases have cropped up in New York City, the Health Department said Wednesday, bringing the city’s total count of possible cases of the rare virus to four.

The city reported the new cases almost two weeks after word of an initial suspected monkeypox case reached the city. Monkeypox is a generally less-severe cousin of smallpox, but infections can be fatal.

Spread of the virus had driven the national tally of infections to 18 by Tuesday, according to the Centers for Disease Control and Prevention.

No known deaths from the disease have so far been logged during the American outbreak. But at least nine people have died of monkeypox this year in Congo, in central Africa, according to The Associated Press.

The virus is typically confined to regions of Africa, but has spread in recent weeks across the globe. President Biden has said that “everybody should be concerned” about the outbreak.

The global tally of monkeypox cases has eclipsed 550, covering 30 countries, Rosamund Lewis, the World Health Organization’s technical lead for monkeypox, said Tuesday on CNN.

The city Health Department tweeted Wednesday that it “will be conducting contact tracing and monitoring and will refer people for care if necessary.”

“Monkeypox is rare in New York City but we can prevent the spread,” the department wrote.

In a statement last week, the Health Department said that a majority of New Yorkers are not at risk of monkeypox infection, but that the virus can “spread through close prolonged contact with an infected person or animal.”

“As a precaution, any New Yorkers who experience flu-like illness with swelling of lymph nodes and rash occurring on the face and body should contact their healthcare provider,” said the statement.

Tim Balk, New York Daily News