Fourteen of the more than 300 U.S. passengers evacuated from a cruise ship hit by the coronavirus outbreak have tested positive for infection during their flights home, U.S. health officials said Monday.

The news comes from a joint statement from the Departments of State and Health and Human Services, CNN reported. The 14 passengers aboard the Diamond Princess, docked in Yokohama, Japan, tested positive for the new COVID-19 virus during the disembarkation process, officials said. They were part of an evacuation process involving two flights back to military bases in the United States.

“After consultation with HHS officials, including experts from the HHS Office of the Assistant Secretary for Preparedness and Response, the State Department made the decision to allow the 14 individuals, who were in isolation, separated from other passengers, and continued to be asymptomatic, to remain on the aircraft to complete the evacuation process,” the agencies said in the news release.

One of the flights landed at Travis Air Force Base near Fairfield, California, around 11:28 p.m. local time Sunday, while the other arrived at Joint Base San Antonio-Lackland in San Antonio, Texas at 3:56 a.m. local time Monday, CNN reported.

All of the passengers aboard the two flights are being closely monitored, the government statement said, and “any who become symptomatic will be moved to the specialized containment area, where they will be treated.” Upon landing, any passengers who test positive or develop symptoms will be sent to “an appropriate location for continued isolation and care,” the agencies said.

Even those patients who do not test positive for COVID-19 or show symptoms will remain under quarantine for 14 days.

The U.S. evacuation was an about-face after a week of reassurances that such a move was not deemed necessary. But the level of danger to the American passengers on board the ship was thought to have become too high to allow them to remain on board. A total of more than 3,700 passengers and crew were on the ship, and more than 200 cases had been reported.

“This is a dynamic situation,” the U.S. Embassy in Tokyo said in an emailed letter to passengers on Saturday, The New York Times reported. The letter explained that, “to fulfill our government’s responsibilities to U.S. citizens,” officials are now recommending “that U.S. citizens disembark and return to the United States.”

In a news briefing on Friday, Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said that “we are concerned that the data coming out of Japan suggests there’s a higher risk among the people on the ship, and therefore their safety is of utmost importance.”

According to the Times, 67 new cases of COVID-19 were reported Saturday on the Diamond Princess — the biggest jump yet recorded in a single day.

Following the U.S. announcement, other countries with passengers onboard have also announced they were looking into options to help stranded citizens, the newspaper reported.

Meanwhile, the COVID-19 coronavirus outbreak — and the global response to it — continues to evolve globally, with the first death outside Asia reported in France on Saturday.

Government officials in France announced the death of an 80-year-old tourist visiting France from the Chinese province of Hubei, the epicenter of the outbreak, died in Paris on Friday, the Times reported. Three other deaths have occurred in Asia but outside of China.

As of Saturday morning, more than 71,000 cases — almost all within China — have been recorded, including 1,775 deaths.

The first case of infection on the continent of Africa was also identified on Friday, involving a person in Egypt who has tested positive for coronavirus but has so far shown no symptoms. The patient is in quarantine in a hospital, Egyptian health ministry spokesman Khaled Megahed told Ahram Online.

In the Friday U.S. news briefing, U.S. health officials said that COVID-19 appears to be most infectious when patients are at the peak of their illness.

“Based on what we know now, we believe this virus spreads mainly from person to person among close contacts, which is defined as about six feet, through respiratory droplets produced when an infected person coughs or sneezes,” Messonnier told reporters.

“People are thought to be the most contagious when they are most symptomatic, that is when they are the sickest,” she added.

“Some spread may happen by touching contaminated surfaces and then touching the eyes, nose and mouth,” she added. “But remember, we believe this virus does not last long on surfaces. Some spread may happen before people show symptoms. There have been a few reports of this with the new coronavirus, and it is compatible with what we know about other respiratory viruses, including seasonal flu. But right now, we don’t believe these last two forms of transmission are the main driver of spread.”

Messonnier also noted that the U.S. Centers for Disease Control and Prevention has launched a new strategy aimed at stemming any potential spread of coronavirus within the United States.

The “CDC has begun working with five public health labs across the U.S. to tap into their ability to conduct community-based influenza surveillance, so we can begin testing people with flu-like symptoms for novel coronavirus,” she said.

“This is an extra layer of our response that will help us detect if and when this virus is spreading in the community,” she said, explaining that samples of flu-like illness that test negative for influenza will then be tested for coronavirus.

Meanwhile, two new cases were confirmed in the United States last week, upping the total from 13 to 15.

Both of the new cases involved quarantined patients who were among the hundreds of American evacuees from China’s Hubei province, the epicenter of the outbreak.

The CDC added that testing of all evacuees is still underway, and “there will likely be additional cases [identified] in the coming days and weeks.”

Just last week, a 60-year-old man living in Wuhan, China, became the first American citizen to die from the new coronavirus.

The man, whose name has not been disclosed, died last week at Jinyintian Hospital in Wuhan, the U.S. Embassy in China said Saturday.

Earlier this month, the United States began to bar entry to any foreigners who have recently traveled to China. U.S. citizens who have recently traveled to the Hubei province of China, where Wuhan, the epicenter of the outbreak, is located, will be quarantined for up to 14 days, U.S. health officials said. U.S. citizens who have recently traveled to other parts of China will face health screenings and voluntary quarantines of up to 14 days.

The temporary entry ban applies to foreign nationals, with the exception of relatives of citizens and permanent residents.

The WHO has already declared the new coronavirus outbreak an international public health emergency.

Experts fear the outbreak could become a pandemic, where there are outbreaks on more than one continent.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

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