NEW DELHI: The number of Covid-19 cases in India rose to 39 on Sunday, with five people from Kerala – a couple and their son who returned from Italy on February 29 and two of their relatives – testing positive for the novel coronavirus Kerala health minister K K Shailaja said the state has been put on high alert in the wake of the new cases, reported more than a fortnight after India’s first three Covid-19 patients, all medical students who returned from Wuhan in China, were discharged.Some reports said one person had died in Ladakh and another in Kolkata. Both were admitted in Covid-19 wards. Union health ministry hasn't yet put them in the list of confirmed cases.The minister said the Kerala couple, in their 50s, and their 24-year-old son did not report either at the airport health desk or their nearest health centre, as is the directive for persons coming from countries affected by Covid-19.Health authorities came to know about their travel history only on March 6, when one of their relatives came to a hospital in Ranni taluk with fever.“Due to the couple and their son’s irresponsible behaviour, two of their relatives have also got the virus now. We have learnt that they have also attended several functions and visited several relatives after their return to Ranni (a small village in Pathanamthitta district of Kerala) where they live,” Shailaja said.The couple and their son, local authorities said, even refused to cooperate with health officials, following which they were forcibly admitted to the isolation ward of the Pathanamthitta general hospital. “As of now their condition is stable,” the Kerala health minister said, adding two nonagenarian members of their family will be shifted to the Kottayam Medical College hospital as a precaution.According to a recent WHO study, based on the assessment of Covid-19 outbreak in China, 88% people with Covid19 had fever. Dry cough was seen in about 68% cases, followed by fatigue (38%), sputum production (33%), shortness of breath (19%), sore throat (14%) and headache in about 14% cases among others.The report also said deaths happen mostly in patients with co-morbidities such as cardiovascular diseases (13.2%), diabetes (9.2%), hypertension (8.4%), chronic respiratory disease (8%) and cancer (7.6%). The WHO report also says only about 2% of patients aged 18 years and under suffered from Covid-19, reflecting the relatively low attack rate in this group. Deaths are also very uncommon among younger patients and most deaths involved elderly people with co-morbidities, according to WHO experts.The Union health ministry said on Sunday that the government was keeping a close watch on the situation and a number of measures have been taken to contain the spread of Covid-19. “Since the disease has spread over more than 90 countries with over 1 lakh cases worldwide, the states and Union territories have been asked to enhance community surveillance as per the list of passengers provided to them,” a statement issued by the ministry said.It added that in view of the rising cases from France, USA and Spain, it has been decided to have dedicated aerobridges of these countries at Indian airports, in addition to the 12 countries (where high incidence of Covid-19 has been reported, for example, China).Among the 39 persons found positive for Covid-19 in India, 16 are Italian nationals who were touring Rajasthan. Two of them are admitted in SMS hospital in Jaipur and doctors said their condition is improving. The rest of them, who are admitted at Medanta Medicity in Gurgaon, are also doing well, sources said.In Assam , at least 400 people have been quarantined after they came in contact with an American tourist who tested positive for the new coronavirus in Bhutan after travelling through the state recently, health minister Himanta Biswa Sarma tweeted on Sunday. In a series of tweets, Sarma said tests for five persons have been done so far and results have come negative.“State health dept has traced more than 400 contacts in different places including MV Mahabahu (cruise ship) and resorts where he stayed. Teams of doctors and microbiologists have been keeping a close watch on these people who have been quarantined,” he wrote.In Tamil Nadu, 27 people who came into contact with a 45-year-old coronavirus patient in Tamil Nadu have been placed under home surveillance.Union health ministry officials said contact tracing of persons who may have come in touch with those found positive for Covid-19 is being done aggressively to contain the spread of the disease. “A total of 52 laboratories have been made functional for testing samples while 57 labs have been designated for helping in sample collection to enhance the capacity for diagnosis and detection of the virus,” said an official. He added that as of March 6, a total of 4,058 samples from 3,404 individuals have been tested by the network, officials said.