Germany has lost track of the spread of coronavirus between civilians, with authorities warning the nation is heading for an epidemic.
It comes as the number of new infections inside China was for the first time overtaken by those elsewhere.
Germany, which has around 20 cases, said it was already impossible to trace all chains of infection, and Health Minister Jens Spahn urged regional authorities, hospitals and employers to review their pandemic planning.
“Large numbers of people have had contact with the patients, and that is a big change to the 16 patients we had until now where the chain could be traced back to the origin in China,” he said.
The coronavirus has spread to Latin America, with Brazil confirming its first known case of infection – a 61-year-old who had visited Italy.
Pakistan’s health minister has also confirmed its first two cases of the virus amid concerns it is spreading rapidly outside China.
Infections have been reported in every continent except Antarctica.
Even as the number of fresh cases declines at the epicentre of the virus in China, there has been a sudden increase in parts of Asia, Europe and the Middle East.
On Thursday, Donald Trump accused media outlets of “doing everything possible” to exploit the situation and make it look “as bad as possible”.
I will be having a News Conference at the White House, on this subject, today at 6:00 P.M. CDC representatives, and others, will be there. Thank you!
— Donald J. Trump (@realDonaldTrump) February 26, 2020
The US president said he will hold a press conference of his own to discuss the virus with officials from the Centers for Disease Control.
Data, as of Thursday morning (Australian time), shows the coronavirus has infected more than 81,200 people globally, with the 374 cases in Italy the most outside Asia.
With 2770 deaths recorded globally, mostly in mainland China, a 60-year-old man recently became the first person in France to die from the virus.
On Wednesday, the number of new infections reported outside China for the first time exceeded the number of new cases in China, WHO Director-General Tedros Adhanom Ghebreyesus confirmed at a briefing in Geneva on Thursday.
“The sudden increases of cases in Italy, the Islamic Republic of Iran and the Republic of Korea are deeply concerning,” he said.
Cases of the coronavirus have been linked to countries such as Iran, Bahrain, Iraq, Kuwait, Oman, Algeria, Austria, Croatia, Germany, Spain and Switzerland, Dr Ghebreyesus said.
“The increase in cases outside China has prompted some media and politicians to push for a pandemic to be declared. We should not be too eager to declare a pandemic without a careful and clear-minded analysis of the facts,” he said.
At this stage, “using the word pandemic carelessly has no tangible benefit” and could “amplify unnecessary and unjustified fear and stigma” as well as paralyse systems, Dr Ghebreyesus said.
“It may also signal that we can no longer contain the virus, which is not true.”
Dr Ghebreyesus urged the international community to have “hope, courage and confidence” that the spread of further infections could be stopped.
He said there have been no new cases in 14 countries in more than a week, while nine other countries have not reported a new case in more than two weeks.
Meanwhile, the US Centers for Disease Control and Prevention is urging Americans to prepare, saying that while the immediate risk there was low, the global situation suggested a pandemic was likely.
Of the 60 US cases, 42 are evacuees from the Diamond Princess cruise ship and 15 related to travel or close contact to American travelers.
“It’s not a question of if. It’s a question of when and how many people will be infected,” the CDC’s principal deputy director Anne Schuchat said.
China’s National Health Commission reported another 406 new infections on Wednesday, down from 508 a day earlier and bringing the total number of confirmed cases in mainland China to 78,064. Its death toll rose by 52 to 2715.
The WHO said only 10 new cases were reported in China on Tuesday outside Hubei.
South Korea, which with 1261 cases has the most outside China, reported 284 new ones including a US soldier, as authorities readied an ambitious plan to test more than 200,000 members of a church at the centre of the outbreak.
Devi Sridhar, a professor and chair of global public health at Edinburgh Medical School, said the spread showed that the outbreak must be taken seriously.
“While COVID-19 is a mild disease in 80 per cent of individuals, the other 20 per cent have severe or critical disease, ranging from shortness of breath to septic shock and multi-organ failure,” Mr Sridhar said.