By Andrew Hay and Hilary Russ

(Reuters) – California is monitoring more than 8,400 people who arrived on commercial flights for coronavirus symptoms from “points of concern,” but the state lacks test kits and has been held back by federal testing rules, Governor Gavin Newsom said on Thursday.

California has only 200 test kits, but has appealed for testing protocols to be expanded to include Americans who may catch the virus as it spreads through U.S. communities, Newsom told a news briefing in Sacramento, the state capital.

Newsom said the U.S. Centers for Disease Control and Prevention (CDC) has assured the state that testing protocols will be advanced and access to test kits will expand “exponentially” in the coming days.

California on Wednesday reported a coronavirus case of unknown origin, making it potentially the first incident of the virus spreading within U.S. communities.

“It is not surprising that we have seen these mini outbreaks occur around the world,” said Dr. Jeffrey Klausner, an epidemiology professor at the University of California, Los Angeles Fielding School of Public Health. “We know the virus is easily spread.”

The female patient, who lives in northern California’s Solano County, was not initially tested for the new coronavirus because she did not meet criteria laid out by the CDC, according to a statement by UC Davis Medical Center in Sacramento, where she is being treated.

REPATRIATED CITIZENS

Dr. Sonia Angell, California’s state public health officer, said local, state and federal health investigators were contacting and isolating individuals who may have been exposed to the patient.

Solano County is the home of Travis Air Force Base, one of the U.S. military bases in California that have acted as quarantine centers for U.S. citizens repatriated from Wuhan, China, the epicenter of the current coronavirus outbreak.

“She had to be exposed from someone else with coronavirus. We know that people with infection were taken to places of isolation or quarantine in that general area,” Klausner said.

UC Davis said no one on its main campus has tested positive for the virus, known as COVID-19, but “out of an abundance of caution,” three campus residents are currently in isolation. One of them, who is showing symptoms of illness, has been tested for the virus, but the results are not yet in.

The CDC’s protocol had called for coronavirus testing in individuals with a fever or respiratory illness who have a travel history or contact that could have led to exposure to the virus.

California officials said this protocol had to be expanded in light of the “inevitable” local spread within the United States. At least 33 people had tested positive for the virus, but five have since left the state, official said.

“The case from yesterday is giving the CDC a lot to consider on revising those protocols so more individuals will be tested,” said Mark Ghaly director of California’s Health and Human Services Agency, referring to the woman from Solano County.

MORE KITS AND PERSONNEL

CDC Director Robert Redfield told a U.S. congressional hearing on Thursday that more test kits were being sent to California and the agency now backs expanded testing.

“When a clinician or a public health individual suspects coronavirus, then we should be able to get a test for coronavirus, so that’s the current guidance that went out today,” he said.

Newsom said the CDC has pledged to send more personnel to California to track the potential spread of the virus.

With new infections reported around the world now surpassing those in mainland China, the World Health Organization’s director general, Tedros Adhanom Ghebreyesus, said on Thursday even rich nations should prepare.

“No country should assume it won’t get cases, that would be a fatal mistake, quite literally,” Tedros said, pointing to Italy, where 17 people have died in Europe’s worst outbreak.

(Reporting by Hilary Russ and Andrew Hay; Additional reporting by Deena Beasley; Editing by Bill Tarrant, Bill Berkrot and Leslie Adler)