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As Italy locked down 50,000 people in 10 towns to contain the first major coronavirus outbreak in Europe — and a fifth person there died from the virus — a growing nervousness pervaded the continent, with officials in nearby countries pledging to keep the outbreak from spreading further.

On Monday, the total number of cases in Italy rose to 219 from at least 152 cases a day earlier, according to Angelo Borrelli, the head of the Civil Protection Agency and the coordinator of the country’s coronavirus emergency response.

More than 100 of those cases are in the northern region of Lombardy. Italian officials on Monday confirmed a fifth death attributed to the coronavirus, an 88-year-old man from Caselle Landi, about 70 kilometers south of Milan. At least 26 coronavirus patients are in intensive care, officials said.

The spike in Italy has already prompted an aggressive response. Besides the lockdown of the 10 towns in Lombardy, where a sizable cluster of coronavirus infections has emerged, Italy also approved emergency measures that apply throughout the country.

Residents on lockdown were supposed to leave or enter their towns only with special permission, and police and military forces were deployed to monitor the entrances to the towns. Officials closed schools and canceled the last two days of the Venice carnival, as well as trade fairs, opera performances and soccer matches.

Mr. Borrelli told the Italian daily Corriere della Sera that the government had set aside 3,000 beds for new patients at military sites.

The virus is also affecting Milan, the country’s economic engine, though the city is not currently under quarantine. The stock market in Milan dropped more than 4 percent on Monday, and many tourist attractions, including the city’s famed cathedral, were closed. The city’s streets felt quieter felt than usual on Monday. Some colleges canceled classes, while international students moved up planned departure dates out of fear of being stranded.

The southern region of Basilicata imposed a 14-day quarantine on people coming from affected northern regions, and passengers from an Alitalia flight from Rome to the African island of Mauritius were given a choice of quarantine or immediate return.

Alitalia said none of the passengers had demonstrated symptoms of the coronavirus but had decided to return to Italy.

The virus presents Europe with perhaps its greatest challenge since the 2015 migration crisis, which radically altered the politics of the European Union and exposed its institutional weaknesses. A spread of the virus would test the fundamental principle of open borders within much of Europe — so central to the identity of the bloc — as well as the vaunted but strained European public health systems.

A European commissioner said the European Union was in constant contact with the authorities in Italy, but the surge of cases has heightened vigilance in neighboring countries. The authorities in Lyon, France, stopped a bus from Milan on Monday and confined the passengers inside after suspicions of a case onboard, the newspaper Le Parisien reported.

The outbreak has killed at least 12 people in Iran as of Monday, state news outlets reported — the largest number of coronavirus-linked deaths outside China.

  • Updated Feb. 10, 2020

    • What is a Coronavirus?
      It is a novel virus named for the crown-like spikes that protrude from its surface. The coronavirus can infect both animals and people, and can cause a range of respiratory illnesses from the common cold to more dangerous conditions like Severe Acute Respiratory Syndrome, or SARS.
    • How contagious is the virus?
      According to preliminary research, it seems moderately infectious, similar to SARS, and is possibly transmitted through the air. Scientists have estimated that each infected person could spread it to somewhere between 1.5 and 3.5 people without effective containment measures.
    • How worried should I be?
      While the virus is a serious public health concern, the risk to most people outside China remains very low, and seasonal flu is a more immediate threat.
    • Who is working to contain the virus?
      World Health Organization officials have praised China’s aggressive response to the virus by closing transportation, schools and markets. This week, a team of experts from the W.H.O. arrived in Beijing to offer assistance.
    • What if I’m traveling?
      The United States and Australia are temporarily denying entry to noncitizens who recently traveled to China and several airlines have canceled flights.
    • How do I keep myself and others safe?
      Washing your hands frequently is the most important thing you can do, along with staying at home when you’re sick.

The country’s deputy health minister said on Monday that at least 61 people had tested positive for the virus. Tehran announced a weeklong closure of schools, universities and cultural centers across 14 provinces in an effort to curb the outbreak.

Experts have said that, based on the number of dead, the total number of cases in Iran is probably much higher, as the illness linked to the virus appears to kill about one of every 50 people infected.

Iran said just days ago that it was untouched by the virus.

Amid evidence that the virus may be spreading elsewhere in the Middle East — with confirmed cases in Bahrain, Iraq and Kuwait all linked to Iran — neighboring nations have put measures in place to try to limit transmissions. Pakistan and Turkey temporarily closed their borders with Iran on Sunday.

Pakistan’s 596-mile border with Iran, a largely lawless area with few border controls, poses particular challenges in controlling the spread of the virus.

In Afghanistan, the National Security Council said on Sunday that all travel to Iran would be reduced to “essential humanitarian needs.” The country’s first coronavirus case was confirmed on Monday.

Within Iran, long lines have formed outside pharmacies, and there is a shortage of masks and disinfectants, according to health officials and people in Iran. Officials have warned that hospitals are overstretched, and urged people to refrain from emergency room visits unless they have acute symptoms.

Although the origin of the outbreak in Iran is unclear, the country’s health minister said that Chinese carriers were a source of the outbreak, the Fars news agency reported on Sunday.

Ahmad Amir-Abadi, a lawmaker who represents Qom in the Iranian Parliament, criticized the government’s response and said that the death toll was much higher than reported, according to Iran’s Labor News Agency. He said that 50 people with the virus had died in his constituency.

But Eraj Harirchi, Iran’s deputy minister of health, called those claims false and vowed to resign if they proved to be true.

“We reject the death of 51. No one has the authority for announcing such news,” Mr. Harirchi said, according to state-run Fars news agency, maintaining the death toll was still at 12.

Investors have been on edge since the start of the crisis, because of the role that China’s factories play in global business and because it is a huge consumer market itself. But fresh reports that the virus is not contained are “signaling alarm bells,” a market analyst at Citigroup wrote Monday.

Oil prices slid as demand for crude waned because of concerns about a widening economic slowdown.

The announcement was striking: Wuhan, the Chinese city at the center of the coronavirus epidemic, would begin easing a sweeping lockdown imposed by officials in late January by allowing some people to leave.

But just hours after news of the change on Monday, the authorities backtracked, saying the announcement had been made in error.

The reversal prompted anger and confusion in China and added to fears that the government was mishandling its response to the virus. The government in Wuhan, a city of 11 million, has previously been criticized as acting too slowly and concealing information about the outbreak.

“I just went to the bathroom and the policy was changed when I came out,” one user wrote on Weibo, a popular Chinese social media site. “Who is Wuhan listening to?”

In the initial announcement, the authorities in Wuhan said that healthy people who did not live in the city and residents who required specialized medical treatment would be eligible to leave.

Such a decision — the first relaxation of a lockdown that has kept millions of people indoors for weeks — would most likely have required approval from the central government in Beijing.

The government deleted the original announcement a few hours later.

In a fresh statement, the authorities in Wuhan said that the original directive had been issued without the approval of top leaders, and that it would “seriously criticize” the people responsible for the error.

South Korea on Monday reported 231 more cases of the virus that causes the disease Covid-19, bringing the nation’s total to 833 cases and seven deaths.

President Moon Jae-in put South Korea on the highest possible alert on Sunday, a move that empowers the government to lock down cities and take other sweeping measures to contain the outbreak.

“The coming few days will be a critical time for us,” Mr. Moon said at an emergency meeting of government officials to discuss the outbreak. “The central government, local governments, health officials and medical personnel and the entire people must wage an all-out, concerted response to the problem.”

Samsung, the world’s largest smartphone maker, said on Monday that it had restarted operations at a factory in South Korea that was shut down over the weekend after an employee there tested positive for the new coronavirus.

Afghanistan declared a state of emergency in the western province of Herat on Monday after health officials confirmed the country’s first case of coronavirus in the region, which shares a porous border with Iran.

“The case was identified right away and measures taken — the patient’s health is under control and there isn’t concern about the individual’s health at this point,” Health Minister Ferozuddin Feroz said.

Mr. Feroz said it was estimated that more than 1,000 Afghans from Herat had traveled over the past few weeks, to Qom, Iran, a place of pilgrimage for Shiite Muslims because of its many shrines. He said officials were identifying those people for more screening and tests. Five were staying in an 80-bed quarantine center that had been established in Herat, he added.

The patient confirmed to have the virus was among five Afghan citizens who had been in Qom, the city where the first cases and fatalities were reported in Iran. They transited through Dubai before returning to Herat, Mr. Feroz said.

Afghanistan’s National Security Council said on Sunday that the country had suspended air and ground transport to Iran and asked for consular services to be limited to “essential humanitarian needs.” Usually, huge numbers of Afghan migrant workers travel back and forth across the border.

Beyond that, the border between the two countries is punctured by extensive smuggling routes, leaving concern even after official measures to limit formal movement.

Reporting and research was contributed by Choe Sang-Hun, Raymond Zhong, Russell Goldman, Javier C. Hernández, Albee Zhang, Elisabetta Povoledo, Austin Ramzy, Motoko Rich, Makiko Inoue, Salman Masood, Emma Bubola, Mujib Mashal, Megan Specia, Steven Lee Myers, Claire Fu and Amber Wang.



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