The Cook Islands has reported its first dengue-related death, amid a significant increase in cases, and reminders to tourists to stay safe.
The country's health ministry said an elderly patient with underlying conditions had arrived to hospital late in the disease's progression, and died on February 2.
Authorities have now announced Operation Namu-26 to raise awareness and promote prevention.
Dengue is a virus passed between people by mosquitos, and Operation Namu-26 will include an increase in insecticide spraying work on the affected islands, as well as a nation-wide clean up to reduce places where water could pool and mosquitos could breed.
The Cook Islands declared a dengue outbreak in May 2025, and more than 500 cases have been recorded there since.
In New Zealand, 86 people had been reported to have contracted dengue, with 75 of those cases connected to travel to the Cook Islands.
A senior health protection officer told RNZ Pacific that New Zealand had also reported 40 suspected cases of dengue since May, in visitors returning from the Cook Islands.
There had been "a significant increase in dengue cases on Rarotonga at the end of December 2025, and again at the end of January 2026", the Cook Islands health ministry said.
Cases had been found on the islands of Rarotonga, Aitutaki, Atiu, Mauke and Mangaia.
Tourist companies would be providing dengue prevention items to visitors, and spraying on their properties following the ministry's guidelines, it said.
Anyone experiencing flu-like symptoms, headache, joint or muscle pain, or rash should "seek urgent medical attention immediately ...so that timely care can be provided".
New Zealand clinician and University of Auckland lecturer Dr Maryann Heather recently told RNZ that one in four people infected with dengue get sick.
Symptoms include headaches, pain behind the eyes, abdominal pain, nausea, vomiting, muscle pain, joint pain, skin rash, lethargy, tiredness, and high fever, and can be severe. The disease can be more dangerous for young children and elderly people.
"If you aren't improving or concerned, you should seek medical attention, especially if you think you have dengue fever after returning from the islands," Heather said.
"It's crucial to educate and warn people travelling back to the islands so they are aware that dengue fever is present, especially since it is seasonal."
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