A US citizen suffering from monkeypox has defied the authorities’ orders in Mexico and first left the hospital and then the country.

The 48-year-old Texas man fled the hospital in Puerto Vallarta on Mexico’s Pacific coast last weekend, Mexican health officials said on Wednesday. Before they could track him down, he caught a plane back to the US.

Upon arrival at the hospital in Mexico, he had symptoms including “cough, chills, muscle aches and pustular lesions on his face, neck and trunk,” Mexican authorities said. He was then tested for monkeypox and isolated before he left the hospital on his own.

The US health authority CDC later informed the Mexican authorities that the patient had returned to the USA and confirmed the monkeypox finding. The man arrived in Puerto Vallarta on May 27 and attended a party at a beach club, among other things. Authorities called on everyone at the party to exercise caution. The man was in Berlin from May 12th to May 16th, in between in Dallas.

Monkeypox is a less dangerous cousin of smallpox, which was eradicated about 40 years ago. The disease begins with a high fever and quickly progresses to a crusting rash. Monkeypox is endemic in several countries in West and Central Africa, so it occurs there constantly and frequently. Recently, numerous cases have occurred outside of these countries, including in Germany.