About 200 Rhode Island residents who have had direct contact with people infected with the novel coronavirus have been asked to quarantine themselves at home, state health officials said in a statement

The self-quarantine comes after three people who went on a school trip to Italy in mid-February with St. Raphael Academy in Pawtucket tested positive for the virus, known as COVID-19. Rhode Island health officials said test results on seven other people are pending.

A 40-year old Rhode Island man who became the first resident to test “presumptively positive” for the coronavirus following a school trip to Europe in mid-February remains hospitalized in stable condition, state health officials said.

A teenager also on the trip with Saint Raphael Academy, in Pawtucket, who also tested positive for the respiratory virus, known as COVID-19, remains at home with mild symptoms, the state’s health director, Dr. Nicole Alexander-Scott, said.  A woman in her 30s who was on the same trip also is being tested, she said.  The woman is on the staff of Achievement First Academy, a charter school in Providence. She also remains at home with mild symptoms.

They are among 38 people -- mostly students and chaperones -- who were on the high school trip to Italy, France and Spain trip Feb. 14 - 22, Alexander-Scott said. All of the people on that trip will be self-monitoring for symptoms at home for 14 days with public health supervision, health officials said. They have been instructed to not go to school or work and to remain at home during the quarantine.

Health officials are cautioning school officials about traveling in Europe but have stopped short advising them to cancel trips. That's "something that we're actively exploring," Alexander-Scott said.

Only one laboratory in the Rhode Island, located at the state health department, is equipped to conduct the testing, state health officials said. Once the lab receives a sample it takes up to 48 hours to get the results. 

State health officials are working with the hospital where the man who tested positive for COVID-19 is currently being treated to ensure all infection control protocols are being followed. State health officials did not release the name of the patient or the hospital.

The test results were sent to the Centers for Disease Control and Prevention for final confirmation, Alexander-Scott said.

“At this point time, the general level of risk for Rhode islanders is low. There is no need for panic, there is no need to be frightened,” Democratic Gov. Gina Raimondo said Sunday at a press conference.

Massachusetts health officials announced Feb. 1 that a student at UMass Boston who had traveled to Wuhan City, China, had contracted the respiratory illness.

The first reported death in the U.S. from the novel coronavirus was confirmed Saturday in Seattle, prompting the governor of Washington to declare a state of emergency.

Most infections result in mild symptoms, including coughing and fever, though some can become more serious and lead to pneumonia. Older people, especially those with chronic illnesses such as heart or lung disease, are especially vulnerable. Health officials think it spreads mainly from droplets when an infected person coughs or sneezes, similar to how the flu spreads.

The number of coronavirus cases in the United States is considered small. But that number is expected to grow, and health agencies have been ramping up efforts to identify those who may be sick.

Outreach to those who have been in direct contact with the person in Rhode Island has begun. The agency said there are extensive efforts underway to ensure those people undergo a period of 14 days of self-monitoring for symptoms at home with public health supervision, also known as a quarantine.

The man in his 40s who was the first to be diagnosed had limited travel in Rhode Island since returning from Italy and had not gone to their place of work since returning. The person’s immediate family members have begun self-quarantining.

The CDC is managing the efforts to trace people on the man's return flight to the United States.

This story has been updated as of 1:00 P.M. Thursday

With reports from the Associated Press.