The U.S. State Department issued a travel advisory on Sunday urging Americans not to travel to two Italian regions hardest hit by the coronavirus, raising the level of warning for the Lombard and Veneto regions to the highest level.

Sunday’s advisory is a level 4, the highest warning the department issues, urging that Americans “Do not travel” to the two Italian regions at the center of Italy’s Covid-19 outbreak.

The advisory cited quarantines set up in ten Lombard towns and one in Veneto, with a combined population of 50,000 people, as well as the ‘’the level of community transmission of the virus.”

It follows an earlier warning late Friday to avoid non-essential travel to all of Italy, where more than 1,100 cases were confirmed through Saturday along with 29 deaths.

On Sunday, the Rhode Island Department of Health confirmed the first case of coronavirus in that state. The patient, according to the department’s press release, “is in their 40s and had traveled to Italy in mid-February.” The release also notes that “[o]utreach to the people who were in direct contact with this individual has already begun, with extensive efforts underway to ensure that they undergo a period of 14 days of self-monitoring for symptoms at home with public health supervision (quarantine).”

American Airlines announced the suspension of flights to Milan, Italy, from New York and Miami after an aircrew refused to fly an assigned route, Breitbart News reported. The suspension is expected to last at least seven weeks.

Enhanced screening measures have been put in place at U.S. airports to screen travelers who have visited China in recent weeks, including checking their temperatures and assessing any other possible symptoms of the virus. Pre-boarding screening measures have been extended to travelers from Italy and South Korea and restrictions have been placed on noncitizens who have traveled to Iran, the New York Times reports.

“To date, arriving travelers who have visited mainland China in the prior two weeks are supposed to be stopped and questioned, but those protocols have not been applied to travelers from other countries where the virus has spread significantly,” according to the Times. The Times quotes a New York University student who returned from Florence, Italy, last week and expressed surprise at not being questions or screened by U.S. customs officials upon her arrival into Washington Dulles International Airport from a region heavily impacted by the coronavirus outbreak.

Italian tourism officials have cited the previous warning covering all of Italy as potentially calamitous to the industry, which represents 13 percent of gross domestic product in a country famed for its world-class museums, archaeological sites, art cities and natural beauty.

More than 5.6 million Americans visit Italy every year, representing 9 percent of foreign tourists and the second-largest national group behind Germans, according to the most recent statistics.

Lombardy, which includes Italy’s financial capital Milan, accounts for just over half of the cases while Veneto and Emilia-Romagna have 18 percent and 20 percent, respectively. All three regions have closed schools for the time being. In Veneto and Lombardy, closures also have hit museums, theaters, cinemas and most public offices, emptying urban centers like Milan, where many companies permitted office workers to telecommute.

Earlier Sunday, the French community church in Rome, St. Louis of the French, closed its doors to the public on after a priest was infected with a new virus.

The church in the historic center of Rome is famous for three paintings by the Baroque master Caravaggio, making it a destination for tourists and the faithful alike. A sign on the door Sunday noted in French that the church had been closed as a precaution by the French Embassy for both Masses and touristic visits until further notice.

The Religious Information Service news agency reported that the church was closed after a 43-year-old priest who had returned to Paris was hospitalized after being infected by coronavirus. The service carried a statement by the archbishop of Paris, Michel Aupetit, who said the priest, who had been living in Rome, returned to Paris by car in mid-February, and tested positive for the virus on Friday. The priest was in good condition, Aupetit said.

It was the first church in Rome closed by the virus. Churches in much of Veneto and Lombardy have closed their doors under widespread measures aimed at containing the spread of the virus. Televised Masses were available for the faithful.

The Associated Press contributed to this report.