Despite fading from the headlines, the latest outbreak of Monkeypox in the U.S. continues.

South Florida became the epicenter and continues to report new cases. With a weekend of Halloween parties that could have lots of skin-on-skin contacts (the primary way Monkeypox is spread), it’s a good time to see where LGBT communities stand.

Nationwide, about 28,000 cases have been diagnosed, with six resulting in death. Florida has seen 2,700 cases, with the vast majority, about 1,700, coming from South Florida. As time goes on, doctors are seeing it start to change.

“We are noticing the presentation deviate a lot from what Monkeypox was suspected to be in the past,” Dr. Zachary Henry, Medical Director for AHF’s Healthcare Center Northpoint in Fort Lauderdale, said. “Presentations where people come with just a sore throat or just rectal pain/bleeding/discharge and their throat/anus is the only site where lesions exist. Also, people with advanced immune suppression [AIDS, HIV positive who are not long-term virologically suppressed, solid organ and bone marrow transplant recipients, people on iatrogenic immunosuppressive medication] can expect they might have a more complicated prolonged course of illness should they be infected.”

Monkeypox is spread through prolonged, skin-to-skin contact, usually with an infected person’s lesion touching the uninfected person. Doctors warn people to look for breakouts before having intimate contact. While some children and cis-gender women have been diagnosed, this outbreak remains centered around men who have sex with men since it originated at circuit parties in Europe.

Vaccinations are available but you need to schedule one. Your doctor or local health department can help get you set up. Dr. Henry said “at risk” unvaccinated individuals are more than 14 times at risk than those who have had both vaccination doses.

Between vaccinations and natural or acquired immunity, the number of cases in the area has dropped from the summer peak.

“Cases have been steadily falling overall since August,” Dr. Henry said. “For me personally I was seeing a minimum of 3 to a record of 12 in one day every day at the clinic from early June until September. Now we are surprised to get one case a week.”

Check here for info on vaccine availability.