Samoa's Apia has been hit with an outbreak of dengue fever type 3 with fifty five confirmed cases which will be sent to New Zealand for further medical testing.
The acting Director General of Health, Robert Thomsen, says the latest number of cases have also to be tested because some patients either have dengue or a combination with the chikungunya virus.
Four people have been admitted to hospital with severe symptoms, but there have been no deaths.
Dr Thomsen says while the impact has been mostly in the Apia urban area, officials fear it could spread more widely.
"And if the numbers warrant, like happened last year with the chikungunya when advices were taken out for schools to be closed, then we will go to that stage."
The Ministry of Health is continuing preventive measures such as spraying incoming flights from American Samoa, and in the hospitals and schools.
The public is advised to use mosquito repellants and mosquito nets as well as long sleeve shirts and trousers to protect them from mosquitoes.
Apia, Samoa Photo: RNZ / Mary Baines