A US aircraft is being sent to Japan to bring back American passengers on the quarantined cruise ship Diamond Princess.
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The US Embassy in Tokyo said in a letter on Saturday to passengers that a chartered plane would arrive in Japan on Sunday evening.
It recommended "out of an abundance of caution" that US citizens disembark and return home for further monitoring.
The passengers would be required to undergo further quarantine of 14 days upon arriving in the US and if they choose not to return on the flight, they would not be able to return home "for a period of time", the letter said.
"We understand this is frustrating and an adjustment, but these measures are consistent with the careful policies we have instituted to limit the potential spread of the disease," it said.
It also said passengers would be screened before the flight and the US government was working with Japan so that any people with symptoms would receive proper care if they could not board the plane.
Japan confirmed it was co-ordinating with the US government for Americans to leave the ship and return home, saying that would ease its burden in resolving the situation.
Other countries might follow suit and ask to bring back their own citizens from the ship before the quarantine period ends next week, a Japanese government official told reporters.
The cruise ship, owned by Carnival Corp, has been quarantined since arriving in Yokohama on February 3, after a man who disembarked in Hong Kong before it travelled to Japan was diagnosed with the virus.
It had some 3700 passengers and crew on board. Another 67 people have tested positive for the virus, Japanese Health Minister Katsunobu Kato said on Saturday, bringing the total to 285 cases, which includes Australian citizens.
Those testing positive are transferred to Japanese hospitals.
Australian Associated Press