Authorities say a measles epidemic sweeping through Samoa continues to worsen with the death toll rising to 25, all but one of them young children.
The government of the South Pacific nation said on Monday that more than 140 new cases of people contracting the virus have been recorded within the past day, bringing the total to about 2200 cases since the outbreak began last month.
Samoa declared a state of emergency nine days ago, closing all its schools, banning children from public gatherings and mandating that everybody get vaccinated.
According to the government figures, those who have died include 24 children under the age of 5, 11 of whom were infants under 12 months.
The other person who died was in their 30s.
Authorities warn anti-vaxxers
The outbreak of the infectious disease, believed to have originated in New Zealand, has swept across the Pacific, but Samoa has been hardest hit due to low vaccination rates.
The Health Ministry estimates two-thirds of its 200,000 residents are vaccinated, while UNICEF puts the vaccination rate even lower at 28-40 per cent.
Declaring a state of emergency earlier this month, the Samoan Government made vaccinations mandatory for all children and adults.
On Friday, a statement from the prime minister's office confirmed the state of emergency orders, including that compulsory vaccination was legally binding.
"Any person that actively discourages or prevents in any way members of the community from receiving their vaccination injection, is hereby warned, to cease immediately, and is similarly warned not to take any further action of that kind."
However, it remains unclear how the orders will be enforced and if there will be any punishments for offenders.
Since the outbreak, Australian-Samoan anti-vaxxer Taylor Winterstein has likened Samoa's actions to Nazi Germany and suggested people are being forced into hiding to avoid getting immunised.
Ms Winterstein, whose husband Frank Winterstein has played rugby for Samoa's national team, instead advocates for vitamin A to be used to treat measles.
A Samoan mother grieves for her child who died of suspected measles. Source: TVNZ
UNICEF is distributing more than 110,000 doses of the measles vaccine, with priority being given to those under the age of 19 and women aged between 20 and 35.
Samoa is rolling out a mass vaccination program in a bid to limit the spread of a deadly measles outbreak. Source: TVNZ
In further restrictions introduced on Friday, pregnant women who have not been immunised against measles have been banned from going to work.
Schools, kindergartens and the country's only university remain closed and anyone aged under 19 is barred from public gatherings.
With additional reporting from Rosemary Bolger
