A national effort is being mobilised to clean-up the main and outer-islands of Palau to prevent dengue fever from spreading further.
There are 14 confirmed and 36 suspected cases of dengue, prompting the Ministry of Health to officially declare an outbreak.
The Public Health Director, Dr Stevenson Kuartei, says it's unusual to have such an outbreak at this time of year, when cases are usually reported in December or January.
He says the environmental health division is actively investigating what mosquitos are around homes and neighbourhoods, and another team is investigating where the disease has come from.
But Dr Kuartei says the number of cases meant more of an effort was needed.
"This particular time though there's been a national effort to do a island clean up. Right now we're actively working with state governors to mobilise all outer-island clean up. All the debris that have been gathered in the neighbourhood are gonna be cleaned."
Dr Kuartei says the situation has been complicated by it's neighbouring island, Yap, having a similar outbreak of the mosquito carried zika fever.