Coronavirus deaths in the United States climbed to nine on Tuesday, with at least 15 states reporting cases in what health officials said could be just the start of the outbreak’s arc in this country.

a group of people riding on the back of a truck: FILE – In this Feb. 29, 2020, file photo, a staff member blocks the view as a person is taken by a stretcher to a waiting ambulance from a nursing facility where more than 50 people are sick and being tested for the COVID-19 virus, in Kirkland, Wash. News organizations must walk a fine line in covering coronavirus. They need to convey the story’s seriousness without provoking panic and report a flood of news while much remains a mystery. At the same time, they have to remind people who to stay safe and keep their own employees well. (AP Photo/Elaine Thompson, File) © Provided by Boston Herald FILE – In this Feb. 29, 2020, file photo, a staff member blocks the view as a person is taken by a stretcher to a waiting ambulance from a nursing facility where more than 50 people are sick and being tested for the COVID-19 virus, in Kirkland, Wash. News organizations must walk a fine line in covering coronavirus. They need to convey the story’s seriousness without provoking panic and report a flood of news while much remains a mystery. At the same time, they have to remind people who to stay safe and keep their own employees well. (AP Photo/Elaine Thompson, File)

“What is happening now in the United States may be the beginning of what is happening abroad,” said Dr. Nancy Messonnier of the Centers for Disease Control and Prevention in a Tuesday telebriefing with reporters.

All of the U.S. deaths have occurred in Washington state and most were residents of a nursing home. The number of infections in the U.S. overall climbed past 100, scattered across at least 15 states, with 27 cases in Washington alone.

The nursing home outbreak apparently seeded the first case in North Carolina, authorities said. A Wake County resident who had visited the Washington state nursing home tested positive but is in isolation at home and is doing well, according to the North Carolina governor’s office.

Messonnier said reports out of China show serious illness is happening in 16% of cases and elderly people or those with chronic health conditions are twice as likely to get very ill from coronavirus.

Gov. Charlie Baker issued a notice to state employees advising precautions and to stay home if they are sick. The Bay State’s two cases are a UMass Boston student who traveled from Wuhan, China, and a Norfolk County woman who traveled to Italy with a school group. New Hampshire Tuesday reported a second case — someone who had been in contact with the first case.

Herald wire services contributed to this report. 

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