Four people are now confirmed to have died from dengue fever as an outbreak of the mosquito-borne virus grips American Samoa.
An epidemiologist for the department of health, Scott Anesi, says lab test results have returned, showing that two recent deaths were a result of dengue fever.
Mr Anesi says people should continue to clear potential mosquito breeding sites, dress protectively and spray themselves with repellent containing deet.
He says the virus is continuing to spread between people coming into contact with others, and is urging people who suspect they have the virus to isolate themselves at home if they're well enough.
