ST. LOUIS, Mo. (AP) — A St. Louis-area woman who recently traveled to Italy is the U.S. state of Missouri’s first confirmed coronavirus case.

St. Louis County Executive Sam Page said Saturday that the woman is in her 20s and is at home with her parents. She was returning home from Italy when she showed symptoms.

Page said the parents are not showing symptoms.

The Missouri announcement came the same day that neighboring Kansas also announced its first case of the virus.

The number of U.S. coronavirus cases swelled to 400, with cases in about half of the states. Indiana, Minnesota, Nebraska and Pennsylvania also recently reported their first cases. The total U.S. death toll has reached 19.