Buncombe health officials confirmed the first case of monkeypox in the county. Buncombe County Health and Human Services says that contact tracing is underway, and the patient is in isolation. There are currently 21 monkeypox cases in counties throughout North Carolina. Local health officials say monkeypox is a rare but potentially serious viral illness that typically involves flu-like symptoms, swelling of the lymph nodes and a rash that includes bumps that are initially filled with fluid before scabbing over. The virus is transmitted from person to person through direct skin-to-skin contact.