Dengue fever cases in the Marshall Islands capital of Majuro have multiplied quickly, jumping to 154 confirmed cases.
The Ministry of Health has also confirmed the first case from an outer island, and says there are suspected cases in Kwajalein, which is the country's second largest urban centre.
A health official says most of the cases seen to date have been mild, although 10 people remain in hospital.
In response to an emergency declaration by the government last Friday, residents on Majuro and Kwajalein launched big cleanups which have been continuing this week.
