The total includes the first death in Beijing, the Chinese capital, and 24 more fatalities in Hubei province, where the first illnesses from the newly identified coronavirus occurred in December.
The U.S. Consulate in the central Chinese city of Wuhan, where authorities cut off most access Jan. 22 in an effort to contain the disease, was preparing to fly its diplomats and some other Americans out of the city. Japan, France, Mongolia and other governments also planned evacuations.
China’s increasingly drastic containment efforts began with the suspension of plane, train and bus links to Wuhan, a city of 11 million people. That lockdown has expanded to 17 cities with more than 50 million people in the most far-reaching disease-control measures ever imposed.
U.S. health officials expanded their recommendation for people to avoid non-essential travel to any part of China, rather than just Wuhan and other areas most affected by the outbreak.
Mongolia closed its vast border with China and North Korea said it was strengthening quarantine measures. Hong Kong and Malaysia are barring visitors from Hubei. Chinese travel agencies were ordered to cancel group tours nationwide.
There were 1,771 new cases confirmed in China on Monday, raising the national total to 4,515, according to the National Health Commission. It said 976 people were in serious condition.
Beijing’s official response has “vastly improved” since the 2002-03 SARS outbreak, which also originated in China, but “fears of a global contagion are not put to bed,” said Vishnu Varathan at Mizuho Bank in Singapore.
Scientists are concerned about the new virus because it is closely related to other diseases including SARS, which killed nearly 800 people.
So far, the new coronavirus doesn’t seem to spread as easily among people as SARS or influenza. Most of the cases that spread between people were of family members and health workers who had contact with patients. That suggests the new virus isn’t well adapted to infect people.
China has reported eight cases in Hong Kong and five in Macao, and more than 45 cases have been confirmed elsewhere in the world. Almost all involve mainland Chinese tourists or people who visited Wuhan.
On Tuesday, Taiwan said two 70-year-old tourists from Wuhan had been confirmed to have the disease, raising its total to seven cases. Thailand reported six members of a family from Hubei were new cases, raising its total to 14.
Germany confirmed its first case late Monday. Infections also have been confirmed in the United States, Japan, South Korea, Vietnam, Singapore, Malaysia, Nepal, France, Canada, Australia and Sri Lanka.
The five American cases — two in southern California and one each in Washington state, Chicago and Arizona — are people who had recently arrived from central China. Health officials said they had no evidence the virus was spreading in the United States and they believe the risk to Americans remains low.
The coronavirus family includes the common cold but also more severe illnesses such as SARS and Middle East Respiratory Syndrome. The new virus causes cold- and flu-like symptoms, including cough and fever, and in more severe cases, shortness of breath and pneumonia.
The virus is thought to have spread to people from wild animals sold at a Wuhan market. China on Sunday banned trade in wild animals and urged people to stop eating meat from them.