The Cook Islands health ministry says there have been two more cases of H1N1 flu.
The ministry says the two cases are residents of the Cooks Islands who have not travelled overseas in the last 20 days, live in two different villages Ngatangiia and Tepuka, and who have had no contact with each other.
One is a 16-year-old male, the other a 33-year-old woman.
They are being treated and are in quarantine at home.
The ministry says social distancing is now a must, advising those who have flu like symptoms not to leave their home to go into the community, attend work or school.
This comes at the peak of the tourism season and coincides with a visit by the New Zealand prime minister, John Key, who is about to conclude his unprecedented four-nation Polynesian goodwill tour.
During his stop in Samoa, Mr Key extended an offer to Pacific island countries to assist in efforts to fight swine flu.
