Another case of dengue fever, which was contracted locally, has been confirmed in Guam.
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Eleven locally-acquired cases have now been detected, while seven cases have been imported during this year's outbreak, the Pacific Daily News reports.
Last month, Guam governor Lou Leon Guerrero declared a state of emergency after the first locally-acquired case in 75 years was recorded.
The Department of Public Health said it was continuing to spray pesticide in areas of surveillance, to kill mosquitoes carrying the disease.
The Aedes aegypti mosquito is the primary transmitter of dengue viruses, which is not found in Guam.
However, the Department of Public Health has said the Asian tiger mosquito, which is present in Guam, can transmit dengue.