American Samoa's Department of Health has concerns about the steady rate at which people are contracting dengue fever.
282 cases of dengue fever, a mosquito-borne disease, were reported in American Samoa for the year to June, up from 249 cases in the same period the previous year.
The Department's health surveillance officer, Sharmain Mageo, says while the number of cases has increased slightly, the bigger issue is they're occurring steadily month by month.
"We do have a concern that we have never actually seen a downfall in dengue fever since last year. Normally we have kind of like a break in cases, we'll have a big surge and then we'll see the cases just go away, but we've been having ongoing cases for the last couple of years."
Sharmain Mageo says the proportion of people becoming re-infected with dengue is also a concern, because it means more American Samoans are getting the less common but potentially more severe type 4 of the disease.