More than 41,000 cases of monkeypox and 12 deaths have been reported from 96 countries, with the majority of cases from the United States, the World Health Organization said on Thursday.

The WHO declared the outbreak a global health emergency in July.

The number of cases reported globally declined 21% in the week ended Aug. 21, after a month-long trend of rising infections, according to WHO’s latest epidemiological report.

“There are signs the outbreak is slowing in Europe, where a combination of effective public health measures, behavior change and vaccination is helping to prevent transmission,” WHO Director-General Tedros Adhanom Ghebreyesus said in a press briefing.

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Still, more than a dozen countries saw a rise in weekly case numbers with the highest increase reported in the United States. Over 34% of the current global case count is in the United States.

The WHO said infections in the Americas region showed “a continuing steep rise” in the previous week.