Gay and bisexual Latino men in Santa Clara County have been disproportionately affected by monkeypox, county health officials said Wednesday, making up more than half of the virus's local cases.

The county has reported 46 confirmed and probable monkeypox cases, as of Wednesday. According to the county's Public Health Department, 21 of those cases have been among Hispanic or Latino residents. The total number of cases in the county rose to 46 on Thursday.

County officials said 41% of local monkeypox cases have been confirmed specifically among Hispanic or Latino gay and bisexual men. Comparatively, Latinos make up roughly one-quarter of the county's population.

White non-Hispanic residents comprise eight of the reported cases, followed by six cases among Asian or Pacific Islander residents and two among Black and African American residents. Two other residents of unknown ethnicity have also contracted the virus, according to the county.

To date, the global monkeypox outbreak has largely spread among gay and bisexual men as well as others who identify as men who have sex with men.

Like most of the country, Santa Clara County has only a modest number of doses of the Jynneos vaccine for smallpox and monkeypox. The county administered the first of two vaccine doses to more than 500 residents at a pair of clinics in the last week, but that amounts to less than half of 1% of the county's 1.9 million residents.

"We are doing all we can to vaccinate the people who need it most, with the limited vaccine supply available," county Health Officer and Public Health Department Director Dr. Sara Cody said in a statement. "We could not do this successfully without the support and collaboration of community partners and health care providers."

County officials opened a monkeypox vaccination clinic Wednesday at the Santa Clara County Fairgrounds Expo Hall for those who are at highest risk of contracting the virus.

All of the clinic's 380 appointments have already been booked through Thursday, but more are expected to open as the county receives more vaccine doses from the state and federal governments.

County officials said they have not been informed of any imminent vaccine deliveries in the immediate future.

"During the (COVID-19) pandemic, the county has become an expert at standing up vaccine clinics to reach the most vulnerable people in our community," said Dr. Jennifer Tong, Santa Clara Valley Medical Center's associate chief medical officer. "We're taking the same approach for monkeypox."

Monkeypox is generally spread through skin-to-skin contact or bodily fluids via kissing, breathing at close range, sexual activity and sharing bedding or clothing. State and federal health officials have stressed that the virus is not airborne like COVID-19 or the flu.

Symptoms can include a rash or sores on the skin anywhere on a patient's body. Contraction of the virus often begins with flu-like symptoms, with a rash or sores often appearing within one to three days.

While many cases have been confirmed among men who identify as gay or bisexual, health experts have stressed that the virus is not exclusive to men who have sex with men, and anyone can contract monkeypox regardless of their sexual orientation.

As of Tuesday, 646 probable and confirmed monkeypox cases have been reported across California, two-thirds of which have been reported in San Francisco and Los Angeles counties alone.

Monkeypox cases have also been reported in Alameda, Napa, Contra Costa, San Mateo, Monterey, Santa Cruz, Solano and Marin counties.

The sharp increase in monkeypox cases over the last two months prompted state Sen. Scott Wiener, D-San Francisco, to call Wednesday for both the city of San Francisco and the state to declare a state of emergency over the virus.

Wiener also chastised the federal government for the slow pace of its response to the outbreak.

"Unfortunately, because our federal government failed to act quickly to acquire the vaccine supplies needed to prevent an outbreak, we are now in a public health emergency that is only going to escalate," Wiener said in a statement. "Given that gay and (bisexual) men and trans people are the most impacted, it's sadly becoming clear that we are being left behind once again."

Information about the monkeypox outbreak, including prevention methods and eligibility criteria for vaccination, can be found at cdph.ca.gov.