ALBANY - A Westchester County man tested positive Tuesday for the coronavirus disease despite no known travel links to countries at the center of the outbreak, leading officials to order hundreds of congregants at his synagogue to quarantine in their home.

The 50-year-old man, who lives in New Rochelle and works as an attorney in Manhattan, is now in stable was in critical condition at the NewYork-Presbyterian/Columbia University Irving Medical Center in Manhattan as of Thursday evening, according to the New York City Health Department.

The man has an "underlying respiratory illness" that has made him more vulnerable to the disease's effects, Gov. Andrew Cuomo said when he announced the test results Tuesday morning.

The case marks New York's second confirmed case of the coronavirus, following a health care worker from Manhattan who remains quarantined in her apartment after returning from Iran.

Unlike the first case, the New Rochelle man had not recently traveled to China, Italy, Iran or other countries hit hardest by coronavirus, raising concern that the virus could have spread locally.

The case spurred a widespread quarantine directive from the county, which directed hundreds of congregants of Young Israel in New Rochelle to remain in their homes through at least Sunday if they attended services or gatherings at the synagogue the weekend before last.

The New Rochelle man is a congregant at the synagogue.

"We said for the past several weeks that with this coronavirus situation, you're going to see continued spreading and that spreading is inevitable," Cuomo said at a news conference at the state Capitol.

"I said you'll start to see community spread cases where you can't track it back directly to one place or one visit, and I think that's what we're seeing today."

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When illness struck

The New Rochelle man first became ill Feb. 22, according to Demetre Daskalakis, New York City's deputy health commissioner for disease control.

He was admitted to NewYork-Presbyterian Lawrence Hospital in Bronxville on Thursday and was treated there before he was transferred Monday to the Columbia hospital.

A test processed overnight at the New York City Public Health Laboratory confirmed the man had the coronavirus disease.

The NewYork-Presbyterian hospital system issued a statement Tuesday, noting it had been ready for a coronavirus case.

“We have been planning and preparing for this situation, and are following rigorous, CDC-recommended isolation procedures for the health and safety of all of our patients, employees, medical staff and visitors," according to the statement.

The New Rochelle man has four children, including a daughter who lives at home and attended SAR Academy's high school in Riverdale, according to Westchester County Executive George Latimer.

SAR, a Jewish day school in the Bronx, voluntarily closed Tuesday amid coronavirus concerns. It will also be closed on Wednesday. Two other modern Orthodox Jewish schools, Westchester Day School and the Westchester Torah Academy, also closed Tuesday, according to Elliot Forchheimer, CEO of the Westchester Jewish Council.

The man has a son who attends Yeshiva University in Manhattan, according to the university. The student hasn't been on campus since Feb. 27, the university reported.

The man's remaining two children were in Israel, according to Latimer.

Quarantined

The man's wife and two children in the country are under quarantine in their New Rochelle home, according to Latimer. The student at SAR was not exhibiting any coronavirus symptoms as of Tuesday, though the Yeshiva student was and is being tested, New York City Mayor Bill de Blasio said.

Yeshiva said it was remaining open but disinfecting “all relevant common areas.” The private university said in a statement that a student at its Cardozo School of Law was quarantining himself or herself – though not experiencing any symptoms – as a precaution because of contact with the ailing man’s law firm.

The family members are congregants at Young Israel, a modern orthodox synagogue in New Rochelle. The father was not at the synagogue last weekend for Shabbat, Executive Director Amy Stein told The Journal News/lohud.

But the man may have been at services and gatherings the previous weekend.

Westchester County issued an alert Tuesday afternoon halting all services at the temple "immediately and for the foreseeable future" due to possible coronavirus exposure.

The order from County Health Commissioner Sherlita Amler came at the direction of the state, according to the county.

Those who attended services on Feb. 22 and a bat mitzvah or funeral at the synagogue Feb. 23 were directed to self-quarantine in their homes through March 8, according to the county.

The quarantine directive is expected to affect hundreds of people, according to the county.

There were also "a couple" medical professionals who may be quarantined after having had contact with the New Rochelle man, according to Latimer.

Outside this case, another 12 individuals remained quarantined and being monitored in Westchester, according to Latimer's office.

Who was in contact?

Major questions remained Tuesday afternoon about who the patient may have come into contact with while he was infected.

While the man had recently traveled to Miami, state Health Commissioner Howard Zucker said he had gone "a while back" before he was contagious. De Blasio said the man also traveled to Israel, though that trip was at least a month ago.

The man works for Lewis and Garbuz P.C., a law firm in Manhattan. By Tuesday afternoon, Latimer's office confirmed the man did commute using the Metro-North Railroad, the commuter rail service serving New York City's suburbs.

Health officials scrambled to map out family members’ recent movements to find people with whom they may have come into prolonged contact. Officials were focusing on seven people at the law firm and looking into close contacts of the man’s children at the Bronx school and Yeshiva University.

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Latimer said it will be up to the Westchester County Department of Health to investigate the New Rochelle's man contact with other people within the county.

"We are going to continue to investigate," Latimer said.

"Certainly, we will be trying to release the information to the degree that we can and keep the public as informed as possible in regards to what they should do."

Cuomo said the state, which recently received federal approval for its own coronavirus test, is quarantining two families in the Buffalo area who recently traveled to Italy, though lab results remain pending.

The governor urged people to remain calm, noting the spread of the virus is similar to the flu.

While the elderly and those with existing respiratory issues must take additional care, most people who contract the coronavirus disease will only display mild symptoms, he said.

Possible signs of infection include fever, cough, shortness of breath and breathing difficulties. In more severe cases, coronavirus can cause severe acute respiratory syndrome, kidney failure and death.

"This is New York," Cuomo said. "We deal with things like this and we're stronger for it."

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Includes reporting by The Journal News staff writer David Propper and the Associated Press.

Jon Campbell is a New York state government reporter for the USA TODAY Network. He can be reached at JCAMPBELL1@Gannett.com or on Twitter at @JonCampbellGAN.

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