APIA, SAMOA AAP - A tiny mosquito lands on its human prey in a small Pacific nation and begins to feast on their blood.
If lucky, they will suffer just an itchy bite but there's the danger they could be struck down with debilitating dengue fever - and this year's outbreak could be the worst ever.
The potentially-fatal disease from the Aedes aegypti mosquito is in pandemic proportions.
More than 500 people have been diagnosed in Samoa, at least 1000 in both New Caledonia and Fiji and close to 900 in Kiribati.
But researchers believe the real number is at least double these figures, because so many people do not seek, or cannot reach, medical help.
In countries, such as PNG and Solomon Islands, other medical problems like malaria cause the fever to go undetected.
Sylvia Roberts, 21, from Samoa knows only too well how dangerous the mosquito's bite can be.
On December 29 last year her 17-year-old brother Francis Roberts died after being bitten while in the nation's capital, Apia.
"Every time he woke up he started talking and would jump on the bed and tried to jump off the balcony. So he like ... he got crazy," Roberts says.
"In the end he was paralysed, he couldn't talk. Then he was gone - just like that," she says snapping her fingers.
Her brother was strong and fit, but that didn't protect him.
"He loved sports, he loved playing rugby and he was a smart kid. He loved accounting and maths. He was never into anything stupid," she explains.
Dr Kevin Palmer of the World Health Organisation says dengue fever has spread widely this year.
"At the Pacific Arts Festival a lot of people went there, and there was a risk of people getting it. There was dengue in Pago Pago (the festival venue) - then they went home and brought it back," he says.
Symptoms vary but are often associated with a fever, headaches, joint pain and a rash.
For most people it is not fatal but as the virus develops, complications can lead to haemorrhagic fever and uncontrolled bleeding.
"When you get to hemorrhagic, you get bleeding in your gums. You can get bleeding under the skin. You poke the skin and get hemorrhaging," Palmer said from his Samoa office.
"The worst kind is the shock syndrome, where your whole circulatory system just shuts down. That is pretty rare," he says, adding that says instead of spending millions guarding against an outbreak of bird flu, more money should be spent on fighting dengue, which occurs in all Pacific countries except New Zealand.
It is not just locals who contract dengue, but tourists too.
Australian aid worker Tim Bryar contracted dengue while working in Samoa.
"Your skin just starts to feel, a bit prickly ... I just started feeling that and I knew something was coming on," he says.
"The next day I just felt terrible," Bryar says.
He has since recovered, but with four strains of dengue in the Pacific, he could fall victim again.
There is no vaccine for dengue, and no specific treatment. Once contracted doctors advise patients to take fluids and rest.
