State officials identified five more cases of COVID-19 Tuesday evening, bringing the total number of Iowans who tested presumptively positive for the disease caused by the new coronavirus to 13.

The five new cases are in Johnson County, and all of the individuals went on the same recent Egyptian cruise as the people in the seven other cases in that county.

Gov. Kim Reynolds said earlier Tuesday the state contacted all 21 Iowans who went on the cruise that ran from late February into early March, and said they are all self-isolated at home.

“The reality is COVID-19 is now here, and we can expect the number of tests and the number of positive cases will continue to increase in the days to come,” Reynolds said. “While this news is concerning, it’s no cause for alarm.”

She said the state is prepared to manage the situation.

Reynolds also said 22 Iowans are on a different cruise ship where others tested positive for COVID-19. That ship is docked in Oakland, Calif. The state is asking the 18 Iowans who plan to return to Iowa to get a health screening before taking a chartered flight back to the state, and after they arrive. Then they will likely be asked to self-isolate for 14 days.

Iowa’s first three presumed cases of COVID-19 were announced Sunday evening, five cases were identified Monday, and five more cases were announced Tuesday, bringing the total to 13.

The reality is COVID-19 is now here... While this news is concerning, it's no cause for alarm. - Gov. Kim Reynolds

Twelve of the cases are in Johnson County and all involve people who went on the cruise in Egypt. Eleven of those are people between the ages of 60 and 81, and one is a middle-aged adult between 41 and 60.

The other case was identified in a woman who lives in Pottawattamie County and recently traveled to California. She is between the ages of 41 and 60, and worked at a Panera Bread, according to a county official. All 13 of these people are self-isolated at home, according to state officials.

Iowa Department of Public Health Medical Director Dr. Caitlin Pedati said Tuesday disease investigators are working on these cases, and the state does not currently see a need to warn Iowans about avoiding any specific places in the state.

“We always balance respect and privacy of individuals with sharing information that the public needs to know, to act on to protect their health,” Dr. Pedati said. “And so again, as we learn more, if there are important messages that we need to share, we’ll certainly do that.”

Reynolds signed a disaster proclamation Monday, authorizing “state agencies to utilize resources including personnel, equipment and facilities to perform activities necessary to prevent, contain and mitigate the effects of the COVID-19 virus.” On Sunday, she fully activated the State Emergency Operations Center in central Iowa.

Reynolds said Iowa is in a “good place” with its testing capacity and said she expects more test materials and federal funding to be available soon.

How many people in Iowa are being monitored for COVID-19?

State officials said Iowa started out with enough materials to test about 500 people, and a total of 86 people have been tested according to IDPH’s latest numbers from Tuesday evening. Forty-six of those tests came back negative, and 27 are pending.

The IDPH is also monitoring 112 people who don’t have symptoms.

The state plans to update these numbers each evening between 5:00 and 6:00 p.m.

As of Tuesday, the U.S. Centers for Disease Control and Prevention’s website listed 35 states and the District of Columbia as reporting COVID-19 cases.

Iowa’s cases are still considered “presumptive positive” cases until the CDC verifies the state’s initial results.

Iowans with questions about COVID-19 can call the state’s hotline at 2-1-1.

What are the symptoms of COVID-19?

Symptoms of COVID-19 can include fever, coughing and breathing trouble, and most people will only experience mild symptoms. But in people with other medical complications, the disease can lead to pneumonia, which can be fatal.

State public health officials say people who feel sick should stay home from work and school, and stay away from others.

“It’s our message to the employers to make sure that their employees know that if they’re sick, they need to stay home…and so make sure that your employees feel confident in being able to stay home,” Reynolds said.

She also said Iowans who have a cough, fever, and shortness of breath should contact their health care provider, and should call ahead before visiting a clinic.

Public health workers are also emphasizing the importance of frequent hand washing with soap and water for 20 seconds.

And they say older adults with other medical conditions are most at risk, and should especially take care to protect their health, including by avoiding large public gatherings and travel.

This post was updated Tuesday, March 10 at 6:39 p.m.