San Mateo County health officials have announced the nation’s first known case of a severe form of mpox that has fueled an outbreak of the disease across Eastern and Central Africa.

The first case in the U.S. of a more severe strain of mpox was reported in San Mateo County, the California Department of Public Health said.

There is no evidence that the strain is spreading in California or the U.S., and the risk of contracting Clade I mpox in the U.S. remains low.