WASHINGTON (DC News Now) — The Centers for Disease Control and Prevention (CDC) said a man from D.C. and a man from Colorado who had monkeypox this summer experienced neurologic complications as a result.

The men, who are in their 30s, were healthy when they contracted monkeypox and subsequent monkeypox-associated encephalomyelitis. Encephalomyelitis is an inflammation of the brain and spinal cord.

The CDC said in the case of the patient from the District, there was no known exposure to monkeypox, and he had not traveled recently. He had not been vaccinated against monkeypox and the CDC couldn’t say what his status was when it came to smallpox vaccination.

In July, he experienced fever and muscle pain. A rash on his face, extremities, and other parts of his body followed. Swabs of a lesion came back positive for monkeypox.

Five days after symptoms started showing, he experienced incontinence and flaccidness of his legs. He was admitted to the hospital where his mental status declined and his interaction and response to his environment was changed. The hospital staff put in a tube to protect his airway and transferred him to the hospital’s intensive care unit. MRIs of the brain and spine and other imaging showed issues that doctors believed were related to the monkeypox infection.

Doctors began treatment after neurologic symptoms started. Eventually, they removed the breathing tube. At that point, he was speaking and able to follow commands. The weakness in his lower limbs seemed to lessen. Other issues, including the lesions he had, healed by five weeks.

He was discharged to intense inpatient rehabilitation, walking with the help of a device.

After providing narratives of the cases in D.C. and Colorado, the CDC said in its Morbidity and Mortality Weekly Report (MMWR) that a lot about the cases was unclear, including what, specifically, triggered encephalomyelitis in the patients. Not knowing that makes the best workup and treatment course in similar cases uncertain.

The CDC encouraged clinicians and public health professionals to be aware of the range of possible clinical presentations of monkeypox infections and potential treatments. It said suspected cases should be reported to state, tribal, local, or territorial health departments to improve understanding of the range of clinical manifestations of monkeypox infections and treatment options.

It added that people who have been exposed to monkeypox or are at higher risk of being exposed to it can be be vaccinated against it. There are other protective measures to reduce their risk for exposure to monkeypox, as well.