The State Department on Thursday night issued an advisory telling Americans not to travel to China because of the public health threat posed by the coronavirus, as world health officials grappled with the expanding footprint of the outbreak.

Secretary of State Mike Pompeo confirmed the travel advisory on Twitter, saying that the department had raised its advisory for China to Level 4 — meaning do not travel there.

Pompeo cited a decision by the World Health Organization earlier Thursday to declare the coronavirus a public health emergency of international concern.

“Travelers should be prepared for travel restrictions to be put into effect with little or no advance notice,” the advisory said. “Commercial carriers have reduced or suspended routes to and from China.”

The State Department said Americans who were in China should consider leaving via commercial transportation. It also requested that all nonessential U.S. government personnel hold off on traveling to China.

In China, at least 213 people had died from the virus as of early Friday, authorities said. The total number of cases worldwide was approaching 10,000, according to Chinese and World Health Organization data. The vast majority of cases were in China.

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The warning by the State Department came on the same day that the first person-to-person transmission of the coronavirus was reported in the United States. An Illinois man had contracted the virus from his wife, who had recently visited Wuhan, China, the epicenter of the virus. Both were hospitalized.

More on the coronavirus outbreak

Also on Thursday, the union for 15,000 American Airlines pilots filed a lawsuit in Dallas County Court in Texas seeking a temporary restraining order to suspend flights to China. The union, the Allied Pilots Association, said that British Airways, Air Canada and Lufthansa had already suspended service to China.

“We estimate that as many as 300 passengers and crew travel to DFW alone from Chinese cities on each American Airlines flight,” Eric Ferguson, the union’s president and a captain for American, said in a statement, referring to Dallas-Fort Worth International Airport, the airline’s largest hub. “To us, that level of risk is unacceptable.”

The union said it had directed American Airlines pilots to decline flight assignments to China unless it was part of a return trip. It said that airline regulations required pilots to remain on the ground in China for about 32 hours so that they could get adequate rest.

The State Department has previously issued Level 4 advisories warning Americans not to travel to at least 12 other countries, including Iraq, Afghanistan, Syria, Yemen, North Korea and Iran, where the department cited the risk of kidnapping and the arbitrary arrest and detention of U.S. citizens.

Other countries placed under a Level 4 travel advisory include Mali, due to crime, terrorism, and kidnapping; Venezuela because of crime, civil unrest, poor health infrastructure, kidnapping, and the arbitrary arrest and detention of Americans; and Burkina Faso, because of terrorism, crime and kidnapping.