Dengue cases reported in the Cook Islands have doubled over the past week despite a major campaign against the mosquito-born disease.
Radio Cook Islands reports that there are now more than 50 cases.
There is speculation the dengue outbreak reached Cook Islands from neighbouring French Polynesia, where dengue is a continuing problem.
The Ministry of Health is using Cook Islands Television, Radio Cook Islands and local newspapers to build public awareness and get people to eliminate mosquito breeding places.
Public servants spent a day on an island-wide cleanup campaign.