The dengue fever outbreak in the Cook Islands shows no signs of abating with the total number of suspected, probable and confirmed cases of type-2 dengue sitting at 317.
Cook Islands news online reports the total number of cases have increased 44 per cent since the beginning of the month.
Cases have been steadily climbing since the outbreak was declared by Te Marae Ora Ministry of Health in early February this year.
The majority of cases have been found in Rarotonga, however single cases have also been identified in Aitutaki and Mauke.
Officials have carried out island-wide clean-up operations and awareness campaigns on both islands.
A total of 35 residents have been hospitalised with dengue-like symptoms during the current outbreak.
This represents about 50 per cent increase in hospitalisations from 23 recording a month ago.
Public health officials said they have carried out spraying for mosquitoes at all of Rarotonga's schools. Officials also said they have sprayed the homes of confirmed cases.
The most common breeding places are unused tyres, followed by empty discarded cans.
While officials have been targeting public areas to halt the breeding of mosquitoes, health officials are also urging the public to play a role in keeping their homes and properties tidy.
Dr Anura Jayasinghe, a public health specialist with Te Marae Ora Ministry of Health, said the public has a responsibility to maintain a clean environment.
"Once we identify a case, we'll do spraying, but it will only target adult mosquitos. If breeding sites are intact, more mosquitos will come from those sites," he said.
Last week, the health ministry confirmed a separate, unidentified virus is spreading amongst residents, who are also exhibiting dengue-like symptoms.
Blood tests carried out on a number of affected residents have returned negative results for dengue, Zika, and Chikungunya.
Cook Islands news online reports it is unknown if Public Health officials are carrying out mosquito control activities at the homes of those who have fallen ill but have tested negative for dengue.