MONTGOMERY, Ala. — The Alabama Department of Public Health is reporting “severe manifestations of monkeypox” in the current outbreak.

As of Wednesday, the state confirmed 140 cases of monkeypox in Alabama.

While the virus can become severe, most cases have been mild, and ADPH says infections are actually on the downturn.

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“We have seen a potential plateauing and possibly a decrease. We are still seeing new cases that are being reported, but the number of new cases seems to be slowing, so that’s an important fact,” ADPH District Health Officer Dr. Wes. Subblefield said.

Stubblefield says most cases are in the Jefferson and Mobile health districts. Jefferson County Director of Disease Control Dr. Wesley Willeford says they’ve given out 1,094 vaccines so far with plenty of appointments still open.

Right now, Jefferson has the most cases in the state at 68, but things are looking up.

“The peak really seemed to be about August, is what we’ve seen locally and what was seen nationally where you see the most cases going on at once. Since then we’ve really seen a gradual and steady decline,” Willeford said.

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He attributes that decline to the vaccine and behavior changes. Monkeypox is contracted through close skin-to-skin contact. It has so far been detected mostly among men who have sex with men, though anyone in contact with bed linens or clothes of someone infected can get it.

Symptoms include a rash, fever, chills and other flu-like symptoms.

Mobile County Health Department Director of Disease Surveillance and Control Dr. Rendi Murphree says while the downward trend is positive, the number of cases is likely underreported.

“It’s a self-limiting condition. The rash in most people will likely heal on its own, so we think there are more cases out there. We worry people maybe aren’t getting tested and that might contribute to ongoing transmission,” Murphree said.

Murphree recommends getting tested and getting vaccinated if you know you’ve been a contact.

Health officials say to talk to your doctor or reach out to your local health department about whether you should get the vaccine.

There’s also an anti-viral drug available for those already infected.