The novel coronavirus has probably been spreading undetected for about six weeks in Washington state, where the first US death was reported this weekend.
A genetic analysis of the virus from a newly diagnosed patient in Snohomish County closely matched that of a specimen from the first known coronavirus patient in the United States, who traveled from China in January.
Trevor Bedford, a computational biologist at Fred Hutchinson Cancer Research Center in Seattle, announced his findings on Saturday night.
The evidence overwhelmingly suggests that these cases are linked through community transmission, Bedford wrote - and that this has been going on for weeks, with hundreds of infections likely.
"This strongly suggests that there has been cryptic transmission in Washington state for the past six weeks," he wrote. "I believe we're facing an already substantial outbreak in Washington State that was not detected until now due to narrow case definition requiring direct travel to China."