There are only five U.S. states where no monkeypox cases have been detected according to the U.S. Centers for Disease Control and Prevention (CDC).
The viral disease has swept across the world in an unprecedented outbreak affecting people in countries outside of West and Central Africa, where it is usually confined to, with no travel links to either.
Globally there had been more than 18,000 confirmed cases as of July 25, almost all of which were in countries that had not historically reported monkeypox. The U.S. has seen 3,846 cases reported so far.
As of July 25 monkeypox had been detected in every U.S. state except Alaska, Montana, Wyoming, Maine and Vermont—though it's possible there are positive cases in these states that have not been detected.

CDC data shows the state with the most cases is New York with 990, followed by California with 356 and Illinois with 344. A state-by-state count can be found on the CDC's website.
Monkeypox is a viral disease that causes a rash to appear on the body that can look like pimples or blisters. It can also cause symptoms like fever, headache, body aches, swollen lymph nodes, chills and exhaustion.
Monkeypox spreads via direct contact with the infectious rash, scabs or body fluids, as well as through prolonged face-to-face contact, touching contaminated items and via infected animals. Pregnant women can also spread the virus to their fetus.
Despite the fact that anyone can catch monkeypox, in this outbreak cases have been concentrated among communities of men who have sex with men (MSM), making them priority groups for the monkeypox vaccine across the U.S.
As of July 22 the U.S. Department of Health and Human Services' Administration for Strategic Preparedness and Response said it had delivered more than 310,000 doses of the Jynneos vaccine, which is indicated for the prevention of monkeypox and smallpox, to states around the U.S. The U.S. government wants to vastly ramp up its available supply to about 7 million by mid-2023.
Some have been critical of the U.S. vaccine rollout in recent weeks, which has been described as too slow to keep up with demand. New York City residents have reportedly faced struggles to get appointments for vaccinations in July, while in Washington State people are even looking out of state to get a shot in nearby Canada, The Seattle Times reports.
Elibigility for the shots differs between states, with some limiting shots to the MSM community, including trans/non-binary individuals, whilst others expand eligibility to sex workers as well.