US health secretary Alex Azar has confirmed a new case of coronavirus in Chicago, as the respiratory illness spreads in the US.

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Also on Sunday, Rhode Island announced its first known case. The new cases came after Washington state confirmed a man in his 50s died from the respiratory illness – the first known death caused by coronavirus in the US.

Azar told Fox News Sunday the Chicago case was one of 23 to be diagnosed in a person who had not been repatriated from Japan or China.

“Of those individuals, we’ve got cases in Chicago as well as Washington and Oregon and two in California where we do not yet know why they contracted the novel coronavirus,” Azar said.

Two other people in Illinois have tested positive for coronavirus: a husband and wife who traveled to Wuhan, China, to care for a relative. They have made a full recovery.

Rhode Island’s health department said a presumptive case was identified there in a person in their 40s who had recently traveled to Italy. The person’s family have been in self-quarantine and efforts are under way to contact others who have been in close contact with them.

Washington governor Jay Inslee declared a state of emergency on Saturday. The man who died was in his 50s and had underlying health conditions and no history of travel or contact with a known coronavirus case.

Eight people have tested positive in Washington, according to the state’s health department. Two of those cases were reported on Sunday as men in their 60s with underlying health conditions.

Another 50 people with symptoms of respiratory illness were being tested at a nursing home in Washington state, where a worker in her 40s and a resident in her 70s tested positive.

Health officials in California, Oregon and Washington are worried because a growing number of people are being infected despite not having visited an area where there was an outbreak, or apparently being in contact with anyone who had.

Azar told ABC’s This Week the increase in cases around the US was what the government had been predicting.

“I think it’s very important that we treat the American people like adults and explain to them that we don’t know where this will go, that we will see more cases, that we will see continued community spreading in the United States, as we’re seeing around the world,” Azar said.

The US has around 60 confirmed cases. Worldwide, according to the World Health Organization, 85,000 people have been sickened and more than 2,800 have died, most of them in China. A 60-year-old US citizen died in Wuhan in early February.

Most coronavirus infections result in mild symptoms including coughing and fever, though some can become more serious and lead to pneumonia. Older people, especially those with chronic illnesses such as heart or lung disease, are especially vulnerable. Health officials think the virus spreads mainly from droplets when an infected person coughs or sneezes, similar to how the flu spreads.

The number of coronavirus cases in the US is considered small, but the increase in diagnoses seems to have stemmed from expanded testing. Azar said 3,600 people had been tested in the US. South Korea has tested more than 35,000.

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The actual ability to test in labs has also expanded after faulty components in a CDC test kit delayed widespread use of the material. On Saturday, the Food and Drug Administration also allowed labs and hospitals to apply for emergency approval of their own tests.

Test kits first sent to labs by the CDC were found to have a faulty component. The agency announced on Friday that it had developed a workaround and people could use those kits again.

﻿At the White House on Saturday, Donald Trump and vice-president Mike Pence, who is leading the federal response, said they would meet with pharmaceutical companies on Monday to discuss expedited development of a vaccine.

Trump will reportedly visit the CDC in Atlanta at the end of next week.