Sydney, July 6 : Health authorities in Australia's most populous state of New South Wales (NSW) warned on Wednesday that monkeypox is likely to be transmitted within the country, as two cases may have been acquired domestically. The NSW health department said 11 cases of monkeypox have been identified in the state, among which nine cases are likely to have been acquired overseas. NSW Health's Executive Director of Health Protection Dr Jeremy McAnulty said the local transmission of the virus may be occurring, particularly among men who have sex with men. "The virus is mainly spread through skin-to-skin contact with the lesions or rarely through close contact with large respiratory droplets from a person early on in their infection," Xinhua news agency reported quoting Jeremy McAnulty. "So far, in the cases we have seen in NSW, monkeypox is not presenting the way some people expect, such as an extensive rash or lesions all over the body." "It could just be a couple of what seem to be pimples in the genital area or buttocks, so people need to pay careful attention to any potential symptoms. Most of our cases to date have presented to sexual health clinics, rather than GPs." But McAnulty warned people to be on alert for all monkeypox symptoms, which can include fever, headache, body aches, and a rash or lesions on the genital area. Patients should immediately get access to health services and make sure they wear a mask as a precaution. The NSW Health statement said monkeypox is a rare viral infection previously associated with travel to Central and West Africa. However, thousands of cases of monkeypox have been reported from several countries that are not endemic to the virus this year, including several European countries and the United States. /IANS