No new monkeypox cases have been reported in Hawaii for more than a month, keeping the total count at 39, according to the Hawaii Department of Health.

Since Sept. 30, the tally has remained at 39, with 27 cases in Honolulu, four on Hawaii island, three on Kauai and two on Maui. Three cases have also been reported among residents out of state.

“It’s been more than a month since Hawaii reported a new monkeypox case,” said Dr. Nathan Tan, Deputy State Epidemiologist, in a statement. “While we are not letting our guard down, this is certainly encouraging news and is reflective of the steps that Hawaii residents took to protect themselves and our community.”

Tan said DOH continues to expand the availability of the Jynneos vaccine, which is available at 14 sites statewide, along with education and outreach efforts.

To date, more than 4,500 total doses of the Jynneos vaccine have been administered in Hawaii, including more than 1,600 second doses. The majority have been administered in Honolulu and to those between the ages of 25 to 39 years old.

Current eligibility is limited to Hawaii residents who have had close contact in the last 14 days with a person with known or suspected monkeypox infection, and those who are gay, bisexual, or other men who have sex with men and transgender individuals who have multiple or casual sex partners.

Nationally, the seven-day average of daily monkeypox cases has declined dramatically, from a daily average of about 440 in early August to just below 30 on Tuesday.

In the U.S., there have been more than 28,600 confirmed monkeypox and orthopoxvirus cases and eight deaths as of today, while there are 78,000 cases globally, according to the Centers for Disease Control and Prevention.

In its latest technical report released Oct. 27, CDC said the vast majority of cases thus far have occurred in adult men and among those reporting sexual contact with other men, and that few cases of transmission to household and nonsexual contacts have been observed to date.

The growth rate of the monkeypox outbreak is slowing, CDC said, likely due to a combination of factors, including vaccination, behavior change, and “possibly increases in infection-acquired immunity among a segment of affected sexual networks.”

Cases are expected to continue slowing and to fall significantly over the new few months, the report said, with moderate confidence. Vaccination remains an important tool in the outbreak.

British researchers, meanwhile, just released a study suggesting monkeypox can spread up to four days before symptoms appear.