The World Health Organization (WHO) on Wednesday declared mpox a global public health emergency for the second time in two years, following an outbreak of the virus in parts of Africa.

That comes as health officials also warn of a sharp rise in cases in Toronto.

On Tuesday, the Africa Centers for Disease Control and Prevention announced that the mpox outbreaks were a public health emergency, with more than 500 deaths so far this year, and called for international help to stop the virus’ spread.

While not considered strictly a sexually transmitted infection, it is spread through contact with bodily fluids or scabs and contaminated personal items like clothing, bedding, sex toys or toothbrushes, according to Toronto Public Health.