The number is questionable. I think it's probably (much) higher. For the US I'd bet my life savings it's much higher.

Monkeypox outbreak in US is bigger than the CDC reports : Shots - Health News : NPR

A misleading case count

On the surface, the monkeypox outbreak in the US doesn't look that bad, especially compared with other countries. Since the international epidemic began in May, the US has recorded 201 cases of monkeypox. In contrast, the U.K. has nearly 800 cases. Spain and Germany both have more than 500.

But in the US, the official case count is misleading, Makofane and other scientists tell NPR. The outbreak is bigger — perhaps much bigger — than the case count suggests.

For many of the confirmed cases, health officials don't know how the person caught the virus. Those infected haven't traveled or come into contact with another infected person. That means the virus is spreading in some communities and cities, cryptically.

[...]

The CDC would not divulge to NPR how many tests have been performed across the country, nor will the agency say where community transmission is likely occurring in the US. NPR emailed the agency multiple times about these questions but the press person declined to comment or provide an interview.

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