India’s first case of the novel coronavirus surfaced in Thrissur, Kerala, where a student who had returned from China tested positive for the deadly virus that has spread to 21 countries within weeks after it emerged in central China.

The state government has placed the girl under observation and treatment in an isolation ward at Thrissur General Hospital and activated emergency protocols to minimise the risk of the spread of the virus, Kerala officials said on Thursday.

The girl had voluntarily reported to health authorities complaining of a sore throat within days of arriving from Wuhan, China, where she was studying medicine.

“The patient is stable and being closely monitored,” the Union health ministry said in a statement.

The girl is among five suspected cases hospitalised in Kerala, health minister K.K. Shylaja said. “We are waiting for the results of the other four samples,” Shylaja said.

The National Institute of Virology, Pune, had until Wednesday tested 49 samples from different parts of the country among which only the sample from the Kerala student tested positive, said Priya Abraham, director of NIV which is receiving nine to 10 samples every day.

“Now a next-gen sequencing test will be done on her sample and the final result will be declared on Friday,” Abraham said.

Shylaja said the patient, if required, would be moved to Thrissur Medical College and Hospital where an isolation ward is ready to manage any suspected cases of coronavirus infection.

She said 806 other people who had one or other symptoms of the viral infection had been quarantined in their homes with strict instructions not to venture outside.

Health authorities have been instructed to backtrack the movement of each of the cases under observation and find all those who had come into contact with them since the outbreak in China.

“Every medical college and general hospital has been asked to create isolation wards,” Shylaja said. “Even private hospitals have been asked to make provisions.”

She drew confidence through how the state had handled its Nipah virus outbreaks in 2018 and 2019. “Drawing from the Nipah experience, we have already deployed emergency protocols that were put in place then,” the minister said.

The Centre on Thursday announced that all travellers who have returned from China since January 15 would be tested for nCoV and iterated that all those who have returned should stay confined to their homes for 14 days.

The external affairs ministry said the Indian embassy in Beijing had established contact with over 600 Indians across Hubei province and was working on travel arrangements to ferry them to the airport. India plans to send two flights to bring back the Indian nationals.

The health ministry said six additional virology labs in Bangalore, Mumbai, New Delhi and Vandanam (Kerala) would test nCoV on Thursday and six labs in Calcutta, Chennai, Jaipur, Lucknow, Nagpur and Secunderabad would start tests from Friday.

The additional labs will reduce transportation and waiting periods, health officials said.

The health ministry said China had up to Thursday confirmed 7,711 cases and 170 deaths from nCoV that had also caused 95 cases in 21 countries, including India.

Most of the deaths have occurred among the elderly and in patients with underlying health disorders, it said.

Doctors in a Wuhan hospital said on Thursday that 50 patients among a set of 99 confirmed nCoV patients had underlying chronic diseases, including cardiovascular and cerebrovascular diseases (40 patients) and diabetes (12 patients).

Li Zhang and his colleagues, in the largest clinical analysis of nCoV patients so far, said most patients were treated with anti-virals (75 patients), antibiotics (70 patients) and oxygen therapy (75 patients) and had recovered well. However, 17 patients developed acute respiratory distress syndrome, of whom 11 had died from multiple organ failure.

Another Chinese research group reported that nCoV appears to use the same molecular doorway to infect human cells as the severe acute respiratory syndrome (SARS)-CoV that had caused a global outbreak during 2002-03. Both groups have published their findings in the medical journal Lancet.