Health authorities in American Samoa are concerned by the deaths of two people from dengue fever as there has not been any increase in reported cases of the disease for some time.
The deaths, which occurred last month, has been confirmed in lab analysis carried out at the Center for Disease Control.
The infection prevention nurse at LBJ Hospital, Sharmaine Mageo, says the deaths of a 10-month-old baby and a 37 year-old male have officials worried.
"We haven't had an outbreak here since 2008-2009, so it really is quite a concern that we are starting off the last couple of months with cases are now coming in positive."
The Department of Health's Epidemiologist Scott Anesi says it unusual that a dengue case which presented as flu like would quickly develop into hemorrhagic dengue.
He says the Department is investigating the two cases and pointed out that the travel history of the two who died is important to determine if they caught dengue in the territory or from neighboring countries.
There's been an outbreak of dengue reported in some nations in Pacific.