The Hawaii Department of Health today said it has identified one additional probable case of monkeypox in an Oahu resident, bringing the total number of cases in Hawaii to five confirmed and one probable.

DOH has also identified connections between all six people, but did not elaborate on the nature of the connections.

“Vaccination and treatments are available, and we encourage anyone with monkeypox symptoms to contact their healthcare provider,” said Health Director Dr. Elizabeth Char in a news release.

DOH said the risk to most Hawaii residents remains low, and that it continues to conduct contact tracing and coordinate vaccination and treatment, which can be effective in controlling monkeypox infection.

DOH reported the first probable case on June 3 in an adult resident that had recently traveled to an area with confirmed cases, and who was hospitalized at Tripler Army Medical Center. On June 8, DOH reported a second probable case in an adult resident who came into close contact with the first.

Then on June 9, DOH reported a third probable case of monkeypox in an adult resident that had no travel history and at the time, no known connection to the first two cases. In mid-June, DOH identified two more probable cases of monkeypox, and said that all five were connected to one another.

Health officials describe monkeypox as a rare disease caused by the monkeypox virus, which is spread from person-to-person through direct contact with body fluids, lesions, or bedding and clothing used by someone with monkeypox.

Monkeypox can also be spread through large respiratory droplets, but these droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required, DOH said.

Infection begins with flu-like symptoms such as exhaustion, fever, headaches, chills, muscle aches and swollen lymph nodes. It then progresses to new or unexplained rash or sores, often on the hands, feet, chest, face, or genitals. Patients generally become ill within 21 days of exposure.

Infection begins with flu-like symptoms such as fever, headache, muscle aches, chills, exhaustion, and swollen lymph nodes. Infection progresses to a rash or sores, often on the hands, feet, chest, face, or genitals. Individuals generally become ill within 21 days of exposure.

Nationwide, monkeypox cases have been disproportionately reported among gay or bisexual men, according to DOH.

In Hawaii, at least some of the cases have been reported among gay or bisexual men, DOH said. However, anyone who has close contact with someone with monkeypox is at risk of infection, regardless of sexual orientation or gender identity.

Individuals with monkeypox symptoms should immediately contact their health care provider, DOH said, but reminded members of the community “to respond with an inclusive, fact-based approach when discussing monkeypox.”

“Stigma is unacceptable and can drive people away from seeking healthcare services,” said DOH in the news release.