The United States told its citizens to avoid China after the World Health Organization declared a global coronavirus emergency, as the Chinese death toll rose Friday to 213 and total infections surpassed the SARS epidemic of two decades ago.

The State Department raised its warning alert to the highest level, telling Americans "do not travel" to China and urged those already there to leave.

Hours earlier, the WHO, which was criticized for initially downplaying the virus threat, changed tack after crisis talks in Geneva.

"Our greatest concern is the potential for the virus to spread to countries with weaker health systems," WHO chief Tedros Adhanom Ghebreyesus as the emergency was declared.

"We must all act together now to limit further spread... We can only stop it together."

Tedros said travel and trade restrictions involving China were unnecessary.

But, with the disease spreading to more than 20 nations, authorities, businesses and worried people around the world were taking matters into their own hands.

Japan on Friday urged its citizens to avoid non-essential travel to China, following similar warnings by Germany, Britain and other nations in recent days.

Those warnings are not as definitive as the US directive against all travel to China.

Among the array of other extraordinary containment efforts, many major airlines this week suspended or reduced flights to China.

Mongolia also halted cross-border traffic with its huge neighbor and Russia sealed its remote far-eastern frontier.

Some countries banned entry for travelers from Wuhan, the city in central Hubei province where the virus first surfaced.

Italy and Israel on Thursday barred all flight connections with China.

Impoverished Papua New Guinea went so far as to bar all visitors from "Asian ports".

China said Friday it planned to send charter planes to bring back Hubei residents who are now abroad, citing the "practical difficulties" that they have encountered overseas. Those from Wuhan will be returned to their quarantined city, the foreign ministry said.

The US reported its first case of person-to-person transmission of the virus on American soil -- a man in Chicago who got it from his wife, who had traveled to Wuhan.

In a sign of growing global fears, more than 6,000 tourists were temporarily confined aboard their cruise ship at an Italian port after two Chinese passengers fell ill. They later tested negative for the coronavirus.

And a pilot union in the United States sued American Airlines to demand it halt all flights to China.

China has taken extreme steps to stop the spread of the virus, including effectively quarantining more than 50 million people in Wuhan and surrounding Hubei province.

But the number of new deaths and cases continues to swell.

The death toll was hiked on Friday to 213 after 43 new deaths, all but one in Hubei. Most deaths have been elderly people.

China's National Health Commission also said Friday that 1,982 new cases had been confirmed, bringing the total to 9,692.

That exceeds the 8,096 cases from SARS (Severe Acute Respiratory Syndrome) a similar pathogen that spread to more than two dozen countries in 2002-03, and killed 774 people, mostly in China and Hong Kong.

Another 102,000 people are under medical observation in China with possible coronavirus symptoms.

The new virus is believed to have emerged in a Wuhan market that sold wild game, and spread by a Lunar New Year holiday season in which hundreds of millions of Chinese travel domestically or abroad.

China has suspended school nationwide and extended the Lunar New Year holiday to limit people traveling.

Thousands of foreigners have been trapped in Wuhan since it was sealed off last week, and countries have been scrambling to organize evacuation flights for their nationals.

France on Friday airlifted around 200 of its citizens from the city. They will be placed under a two-week quarantine back home.

Britain followed suit within hours, extracting 110 British and foreign nationals.

"It's sad to leave a country which you're attached to," Adrien, a 26-year-old French auto industry employee, told AFP before the flight. "We're also relieved because we don't know how things will turn out in China."

Japan and the United States were the first to fly citizens out on Wednesday.

Others that have done so include South Korea and India.

Three people aboard Japan's first evacuation flight tested positive after landing back home, two of whom showed no symptoms, underscoring the difficulty detecting the coronavirus.

Japan has drawn criticism by allowing its evacuees to "self-quarantine".

The WHO has declared a global health emergency five times since the practice began in 2007 -- for swine flu, polio, Zika and twice for Ebola.

It allows the UN health body to issue recommendations that the international community is expected to follow.

Global stock markets have been pummelled after corporate giants including Toyota, IKEA, Starbucks, Tesla, McDonald's and others temporarily froze production or closed large numbers of outlets in China.

But investors took some heart Friday after the WHO recommended against trade and travel restrictions for now, with Asian markets opening higher.

Throughout China, evidence of fear multiplied, with makeshift barriers going up in some residential neighborhoods.

source: AFP