The number of new cases and related deaths from the new coronavirus rose Wednesday in mainland China, Chinese health officials said, while the discovery of new cases outside the mainland indicated the increasing spread of the outbreak.

However, despite its increasing detection in numerous countries, the World Health Organization said the outbreak of the new coronavirus has not yet reached the level of a pandemic. Dr. Sylvie Briand, WHO’s director of epidemic and pandemic diseases, told reporters in Geneva Tuesday the outbreak is at the phase “where it is an epidemic with multiple foci.”

As of Wednesday, at least 490 people, the majority in mainland China, have died from the coronavirus since it was first detected in December in the central Chinese city of Wuhan, with the total number of confirmed infections exceeding 24,000. There are about 150 confirmed cases in 23 other countries, including one death in the Philippines — the first outside of China.

The epidemic has also been detected on the high seas. Japanese officials said 10 people tested positive for the coronavirus on a cruise ship quarantined at the Japanese port of Yokohama. They said the more than 3,700 remaining passengers and crew will remain quarantined onboard Carnival Japan’s Diamond Princess for further testing.

Two U.S. based airlines on Wednesday announced plans to temporarily suspend flights to Hong Kong. American Airlines and United Airlines said they were halting flights there through February 20.

Meanwhile, medical workers in Hong Kong staged a second consecutive day of strikes Tuesday as the Chinese territory reported its first death from the coronavirus.

Hong Kong shut down nearly all land and sea border crossings with the mainland at midnight local time after more than 2,000 medical workers walked off the job Monday demanding that all border crossings be closed completely. Hong Kong was hit hard by severe acute respiratory syndrome (SARS) in 2002-03.

Hong Kong health authorities identified the victim as a 39-year-old male with a pre-existing illness who had recently visited Wuhan.

Also Tuesday, the Chinese gambling territory of Macau said it will temporarily shut down all casino operations for two weeks to help curb the spread of the virus.

A new study published Monday in the journal Nature said experts from the Wuhan Institute of Virology, which specializes in the study of viruses, say the new virus is 96% genetically identical to one found in bats in southern China’s Yunnan province.

The study said the new coronavirus is 80% genetically similar to the SARS virus that killed more than 800 people in 2002 and 2003.

Chinese officials do not know exactly how the virus could have been transmitted from animals to people, but believe open-air markets in China, where wild and domesticated animals are sold, maybe a contributor.

WHO said it expects the number of cases to grow as test results are returned on thousands of pending cases.

Chinese authorities have tried to stop the spread by instituting bans on movement in certain regions and extending holidays to keep people away from schools and other large gatherings.

Beijing, however, is upset that a number of countries are restricting travelers China from crossing their borders.

Government spokeswoman Hua Chunying accused the United States of spreading fear and not offering any substantial assistance in response to the outbreak.

She said Washington has “unceasingly manufactured and spread panic,” noting that the WHO has advised against travel restrictions.

U.S. President Donald Trump has offered to send experts from the Centers for Disease Control and Prevention to China, but Beijing has yet to accept the offer of help.

The United States began mandatory 14-day quarantines Sunday for U.S. citizens who had been in Hubei province, of which Wuhan is the capital. But non-U.S. citizens who have been in China over the past two weeks are barred.

Chief Pentagon spokesman Jonathan Rath Hoffman said Monday the United States is already prepared to provide housing for up to 1,000 people who may need to be quarantined. He also said the United States is “always planning for eventualities and how we may be asked by civilian partners to assist.”