The US state of New York and the city of San Francisco on Thursday declared public health emergencies over local monkeypox outbreaks. <i>Politico</i> reported this week that US President Joe Biden's administration may declare a federal public health emergency over the national spread of the disease. US Health and Human Services Secretary Xavier Becerra — who has the authority to declare a such an emergency — said in a call with reporters on Thursday that the country could still gain control over the outbreak, but he faced criticism for the administration's slow response and limited vaccine supplies amid rising cases. US Centres for Disease Control and Prevention (CDC) data on Thursday showed that 4,639 cases have been reported nationally, a jump from the 3,500 recorded on Wednesday, putting the country in the lead in terms of known infections. New York's state health commissioner declared the monkeypox outbreak an imminent threat to public health. It leads US states in number of cases, with 1,341 infections, which includes 1,251 in New York City alone. “With more than one quarter of all cases in the US, New Yorkers, and especially our LGBTQ+ community, remain among the hardest hit,” New York Governor Kathy Hochul said in a statement on Thursday. “We will continue to advocate to the federal government for our fair share of vaccines based on the disease burden impacting New York.” Demand for monkeypox vaccines in the Big Apple is high, as appointments are snapped up within minutes online. The city health department has decided to prioritise first doses for the two-dose regimen of the JYNNEOS vaccine, leaving those with first doses not knowing when their second shot will be given. The California city of San Francisco says it has become a monkeypox epicentre in the country, with more than 260 infections. “San Francisco needs more support, and we need more action. That’s why we are declaring a Local Emergency,” Mayor London Breed said in a statement. The current outbreak in the US and globally is mainly affecting gay men. Human-to-human spread of the disease can be experienced through sex and close contact as well as interacting with clothing or items used by someone infected with the disease. The US has not reported any deaths from monkeypox, but the disease requires a 21-day isolation period and those infected can experience painful rashes and lesions.