The number of monkeypox cases in Hawaii has grown to 30, two more than reported last Thursday, according to the state Department of Health.

It is unclear where the two new cases were identified, but DOH’s tally since the state’s first reported case in June now includes 20 for Oahu, three for Hawaii island, two for Kauai County and two for Maui County. Three cases were identified in residents out-of-state.

The new cases are now reported on DOH’s dashboard online and listed by county of diagnosis.

In the U.S., total monkeypox and orthopoxvirus cases reached 22,630 as of today, according to the Centers for Disease Control and Prevention. Monkeypox has now been reported in all 50 states, the District of Columbia and Puerto Rico.

Monkeypox causes fever, headache, muscle aches, backache and swollen lymph nodes, along with exhaustion and severe rash, according to CDC, with illness typically lasting two to four weeks. Those who contract monkeypox may experience all or only a few symptoms, with some only getting a rash.

CDC today also reported that two cases of monkeypox-associated encephalomyelitis, which is rare, were identified over the summer.

The two cases were reported in previously healthy, gay young men in Colorado and the District of Columbia with no known exposure to monkeypox or recent travel history. Both were not vaccinated against monkeypox.

CDC said suspected cases of neurologic complications of monkeypox should be reported to state, local, or territorial health departments.

Monkeypox is spread through close, personal, often skin-to-skin contact including direct contact with rashes or the bedding or towels used by someone with monkeypox. While generally less severe than smallpox, it can be a serious illness.

Hawaii is offering the Jynneos vaccine for monkeypox — a two-dose series administered at least 28 days apart — to eligible residents statewide. More than 2,200 doses have been administered in Hawaii, so far, and appointments for second doses are encouraged.

Vaccination eligibility includes:

>> Those who have had close contact in the last 14 days with a person with known or suspected monkeypox infection;

>> Those who are gay, bisexual, and other men who have sex with men and transgender individuals who have multiple or casual sex partners (e.g., such as through dating apps).

All vaccination sites are primarily offering intradermal vaccination, which is administered under the skin instead of into the muscle tissue, according to DOH, which allows for up to five doses to be given per vial.

DOH says this technique provides the same, high level of protection from monkeypox virus while allowing more people in Hawaii to be protected.

Appointments for the Jynneos vaccines can be scheduled via DOH at 808-586-4462 or at health.hawaii.gov/docd/mpxvax. Parental consent is required for those under 18.

Other providers of the Jynneos vaccines include:

Oahu

>> Waianae Coast Comprehensive Health Center (Waianae and Kapolei) 808-427-0442

>> Hawaii Health & Harm Reduction Center (Honolulu) 808-521-2437

>> Kaiser Permanente on Oahu (Mapunapuna) 808-432-2000, prompt 1

Maui

>> Malama I Ke Ola 808-871-7772

Kauai

>> Malama Pono Health Services 808-246-9577

Hawaii island

>> Hamakua-Kohala Health 808-930-2751