Further restrictions could be imposed in Fife if a significant rise in Covid-19 cases continues in the region.
Director of public health Dona Milne warned action may have to be taken if the number of positive results keeps increasing sharply.
She has urged Fifers to stick with the national Covid-19 measures after a rapid rise in the number of clusters locally, including in schools, workplaces and individual households.
Gatherings and the sharing of vehicles have accelerated the spread, she said.
So far, the virus has been identified in 14 schools and Sinclairtown Primary in Kirkcaldy has had to close after a number of classes were hit.
Businesses including Kettle Produce and the Dunfermline Amazon depot have also reported several cases.
Overall cases rose by 84 last week and a further rise in the last seven days brings the total number diagnosed in Fife to 1,331.
Ms Milne said the numbers were significant and added: “I’m concerned we may have to consider further restrictions in Fife if we continue to see a rise in cases.
“Covid-19 can potentially be deadly and over recent weeks we have seen a particularly sharp and significant increase in the number of positive cases locally.
“There is clear evidence that both gatherings involving multiple households and the sharing of vehicles have accelerated the spread of the virus in Fife.
“This has resulted in many more people contracting Covid-19 and a small number of people requiring admission to hospital.”
She said an even greater number of close contacts had been asked to self-isolate in a bid to contain the virus, causing considerable disruption and preventing many from attending school or work.
NHS Fife is launching a new “Stick With It” campaign urging Fifers to follow the rules on household gatherings, social distancing and hygiene in the hope of reducing the spread.
Ms Milne said it was crucial that anyone asked to self-isolate did so and that anyone with symptoms such as a high temperature, a new and continuous cough or a loss or change to the sense of smell or taste arranged a test.
“Covid-19 is often spread by those with little or no symptoms at all,” she said.
“If we are to protect the most vulnerable in our communities and avoid further restrictions like we have seen in other parts of Scotland, then we must continue to take the virus seriously.
“We need people to stick with the rules around gatherings, avoid sharing vehicles with those outwith their own households, avoid crowded places where possible and wear facing coverings where physical distancing is difficult.”
