Health officials in American Samoa are now attributing a disease outbreak to what they call a dangerous form of diarrhoea caused by germs from human waste.
The numbers affected are now up to 165 after first being reported three weeks ago.
14 have been hospitalised.
An epidemiologist Mark Durand says 56 of the cases are positive for amoebic dysentery which he says is thought to be due to a parasite and cases of shigella have also been found.
But he says the epidemiology shows no common source.
"It doesn't a particular store, a particular eating place, a particular event, a particular part of the island, a school, a workplace, a food source that seems like it is the unifying factor behind all of these cases."
An epidemiologist Mark Durand
