American Samoa will now refuse to accept passengers arriving directly from Tonga unless they first transit via Samoa and acquire medical clearances. 

The American territory revealed the tightening of its incoming travel restrictions in an advisory issued this week. 

Talofa Airways flies directly between Tonga and Pago Pago once a week. But its passengers will no longer be allowed to directly enter the American territory without first travelling to Apia and self-quarantining for two weeks. 

To date the coronavirus has killed more than 560 people worldwide and infected more than 28,000 people. The vast majority of recorded cases remain in China, but infections have been recorded in over 25 countries.

Close to 60 million people remain under lockdown in China across three cities.

All travelers from Tonga, including US passport holders and permanent residents entering on Talofa Airways, are required to first enter Samoa, where they must spend a minimum of 14 days and undergo an exam by the Ministry of Health within three days of their departure. 

The same restrictions apply to international travelers arriving in American Samoa via Samoa en route from other international destinations. 

Passengers only moving between Samoa and American are not required to meet the same requirements but must carry proof that they have received a measles, mumps and rubella vaccination at least one fortnight before they departed. 

Children less than 12 months are not allowed to travel.

All entry permits for foreigners will go through up to 30 days' processing time. Authorities also require health and travel declaration forms to be completed in addition to the usual requirements for proof of identity and travel.