Health authorities expect the tuberculosis at Palmerston North Boys' High School to spread.
Mid Central Health, the district health board covering the region, has been testing all 1800 students, teachers and families after a year nine student was hospitalised with TB on August 16.
A total of four boys are now being treated for the disease, which acting medical officer of health Lester Calder described as "unpredictable".
"Some cases are far more infectious than others and you can never quite predict exactly what's going to happen until you've got all the evidence in," he told National Radio.
"But because we've found three suspected cases among the original lot to be tested, I'd be fairly surprised if there weren't a few more."
Anyone who tested positive for exposure to TB underwent a chest x-ray and was monitored for symptoms of the active disease.
Dr Calder said three boys who had been in contact with the original boy had showed signs of active TB.
It would not be known for a few months whether it was TB, but it was looking quite likely, he said.
School principal Tim O'Connor said the school had been trying to carry on as normal but had learned a lot from the situation it had found itself in.
"Probably the one key thing from an educational point of view is that we have really worked hard at keeping our parents informed - probably we've been a little pedantic about that."
Parent Teacher Association (PTA) chairman Ed Rose told National Radio the school had done a good job in keeping both the boys and their parents informed.
"Naturally there are some concerns by both boys and parents but communication is ensuring that anxiety and concerns about this TB outbreak are kept to a minimum."
Mid Central Health was co-ordinating the response at the school, he said.
Disruptions to the school routine had been minimal, Mr Rose said.
More than 100 students and teachers had already tested positive for exposure to the disease and had been put on a six-month course of antibiotics to prevent active TB developing.
The symptoms of TB include a persistent cough, bloody spit, weight loss, sweating and chills during sleep, fever, shortness of breath and excessive tiredness or fatigue.
- NZPA
Health authorities expect more TB cases at school
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