New story in Health from Time: Passenger Confirmed to Have Coronavirus After Leaving Cruise Ship That Docked in Cambodia

A passenger on a cruise ship that was denied entry from several countries amid concerns about the spread of a deadly coronavirus was confirmed to be infected with the novel coronavirus after she and her husband disembarked when the ship was allowed to dock in Cambodia.

The confirmation of an infection on the ship has raised concerns about the virus’ further spread, and authorities are scrambling to confirm if other passengers might be infected, potentially spreading the virus to countries it has not yet reached.

The 83-year-old American woman, who had been on board the Holland America Line ship the Westerdam, was stopped at the Kuala Lumpur airport in Malaysia after going through thermal temperature scanners, and later tested positive for the coronavirus, officially named called COVID-19, according to the Malaysian Deputy Prime Minister Wan Azizah Wan Ismail.

Her 85-year-old husband, who is also an American citizen, has been tested twice for the virus, but the results were negative.

Japan, the Philippines, Taiwan, Thailand, and the U.S. territory of Guam had all denied the ship’s entry, on concerns over the outbreak, despite repeated statements from cruise officials that there were no known cases of the virus on board, before Cambodia agreed to allow the ship to dock.

Hundreds of other passengers have also left the ship, and they are heading to destinations on several different continents. A 66-year-old passenger from Australia, Ann-Maree Melling, tells TIME that after leaving the Westerdam, she and her husband stayed in Phnom Penh in Cambodia before flying to Bali, where they are now vacationing. The couple’s flight had a stopover in Singapore.

“We are in close coordination with some of the leading health experts from around the world,” said Dr. Grant Tarling, Chief Medical Officer for Holland America Line said in a post on its blog. “These experts are working with the appropriate national health authorities to investigate and follow-up with individuals who may have come in contact with the guest.

Melling said that she and her husband plan to check in with their doctor when they get home later this month. “We both feel it would be irresponsible not to,” she said.

It is unclear when or where the infected woman caught the virus, which has sickened more than 70,000 people in 25 countries and killed 1,775. The cruise line issued a statement saying that the woman did not appear sick while on board.

“During the voyage there was no indication of COVID-19 on the ship,” the cruise line said on its blog. “The guest who tested positive did not visit the ship’s medical center to report any symptoms of illness.”

According to the company, all passengers and crew were screened for illnesses and had their temperatures taken, and upon disembarkation the passengers underwent an additional health screening and were required to fill in a written health questionnaire.

The Cambodian government said everyone on the ship had been screened for the virus in collaboration with the World Health Organization and the Centers for Disease Control and Prevention. Melling said she was given a health questionnaire and had her temperature taken before disembarking in Cambodia, in Singapore and again upon arrival in Bali.

But COVID-19’s sometimes mild symptoms mean that it can be difficult to detect. And estimates vary for the average incubation time of the disease from around 3 to 5 days, though some researchers in China say that in rare cases, the incubation period could be as long as 24 days.

The Westerdam is not the only cruise ship to be caught in the middle of the coronavirus outbreak. The virus-stricken ship Diamond Princess was put under quarantine at the Yokohama Bay in Japan on Feb. 5 and infections aboard continue to rise. As of Sunday, at least 355 of the 3,700 passengers and crew are confirmed infected with COVID-19. At least 40 Americans are among those infected, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.