The United States on Tuesday reported its first case of a new virus that emerged in China and has killed nine people in the country and sickened hundreds of others, AFP reported.

A man in his 30s, living near Seattle, was affected by the virus but is in good condition now, officials said. He is being “hospitalised out of an abundance of precaution, and for short term monitoring, not because there was severe illness,” Washington State health official Chris Spitters said.

Li Bin, deputy director of China’s National Health Commission, said on Wednesday morning that the toll in China has risen to nine, and 440 people are infected, the South China Morning Post reported. All of the deaths were reported in central Hubei province. The Chinese government is now enforcing stricter quarantine measures, the newspaper said.

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“The virus is mainly transmitted through the respiratory tract,” Li said. “It may mutate and there is risk of further spread. Now, during Chinese New Year, the surge [in people moving around the country] increases the risk of the epidemic’s spread and the difficulty of prevention and control. We must not take it lightly.”

The coronavirus is part of same family as the severe acute respiratory syndrome, or SARS, and the Middle East respiratory syndrome. The city of Wuhan in Hubei province is the epicentre of the outbreak.

The Macau autonomous region of China on Wednesday reported its first case of the virus, AFP reported. Authorities ordered the staff in all casinos in the region to wear face masks. Macau, the only place in China where gambling is allowed, is a major tourist attraction.

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The case was that of a 52-year-old businesswoman from Wuhan who arrived in the city by high-speed rail on Sunday, via the neighbouring city of Zhuhai. “A series of tests found that she was positive for the coronavirus and had symptoms of pneumonia,” Lei Chin-lon, the head of Macau’s health bureau, told reporters. The two persons she had been staying with at the New Orient Landmark Hotel are being monitored since the woman was admitted to hospital on Tuesday.

The American man who contracted the virus had travelled from Wuhan to the US on January 15, two days before health screenings began for those travelling from China at airports in Los Angeles, New York and San Francisco. Officials from the Centers for Disease Control and Prevention will now be stationed at Chicago and Atlanta airports as well, and travellers flying in from Wuhan will be redirected to one of these five airports.

Though he did not visit the seafood market that is thought to be the epicentre of the outbreak, he approached authorities himself after reading news reports, officials said.

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Several countries have stepped up medical screening of travellers from China, particularly those from Wuhan. The outbreak has cast a shadow over Lunar New Year celebrations. Hundreds of millions of people in China are expected to travel over the course of the new year period, both within the country and overseas.

The Ministry of Civil Aviation on Tuesday directed seven airports – Delhi, Mumbai, Kolkata, Chennai, Bengaluru, Hyderabad, and Kochi – to make arrangements to screen passengers arriving from China. Australia, Bangladesh, Japan, South Korea, Hong Kong, Nepal, Singapore, Malaysia, Russia and Vietnam also implemented stricter screening measures.

The World Health Organization will hold an emergency meeting on Wednesday to decide whether to declare a global public health emergency over the disease. It has so far also been detected in Thailand, Japan, South Korea and Taiwan.

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Fears that this outbreak could be severe emerged after Chinese scientist Zhong Nanshan, who had helped uncover the scale of the SARS outbreak in 2002-’03 that killed 774 people, said the new virus was contagious. “Currently, it can be said it is affirmative that there is the phenomenon of human-to-human transmission,” Zhong had told state-owned CCTV on Monday, according to AFP. Zhong, who works at the country’s National Health Commission, said human-to-human transmission was behind at least one confirmed case in Wuhan, and the infections in two families in Guangdong province.

“As soon as it spreads from human to human, quarantine must be the first priority,” Zhong said at a press conference on Tuesday. “At the moment, I don’t think quarantine has been implemented thoroughly enough.” Zhong is heading a government task force to handle the epidemic.

Meanwhile, Jiao Yahui, deputy director in charge of medical affairs with the National Health Commission, said that 15 medical staff in Wuhan have been infected with the virus. He said this showed that there are “weak links” in preventive measures at medical institutions.