Updated

The top U.N. relief official urged the world Thursday to step up efforts to reach as many as 3 million people left homeless by the South Asian earthquake with winter approaching.

The deaths of three survivors from tetanus (search) reinforced fears that disease and infections will drive the death toll of 79,000 far higher.

In a frantic effort to get supplies to remote villages, helicopters and foot soldiers headed out of the shattered city in the heart of Pakistan's earthquake zone, Muzaffarabad, with medicine and food. Relief workers fear casualties will rise as winter arrives. Snow already has begun to fall in high mountains and temperatures dropping below freezing.

The death toll in South Asia's Oct. 8 quake jumped dramatically to more than 79,000 after regional authorities reported new figures based on bodies recovered and information from outlying areas, making it one of the deadliest temblors of the past century.

The Pakistani government's official toll is 49,739 dead and more than 74,000 injured, but central government figures have lagged behind regional numbers. The regional figures, from officials in Pakistan's North West Frontier Province (search) and the Pakistani-controlled portion of Kashmir (search), add up to about 78,000. India reported 1,360 deaths in its part of Kashmir.

The World Health Organization (search) said three survivors died of tetanus.

The first of an additional 20 U.S. military helicopters will arrive by the middle of next week to help with relief distribution, U.S. Rear Adm. Mike Le Fever said.

A dozen U.S. military helicopters are ferrying supplies and evacuating victims from remote areas in Pakistani territory. Another five helicopters, used by the State Department for drug surveillance, have also been redirected to relief efforts.

In Geneva, top U.N. relief coordinator Jan Egeland (search) appealed to NATO and other donors to step in with "a second Berlin air bridge" of helicopters flying in relief supplies and evacuating perhaps hundreds of thousands of people from damaged areas of Pakistan and India.

Egeland said he could foresee nonstop flights reminiscent of the U.S. and British airlift of essential supplies to West Berlin in the late 1940s when Soviet forces cut the city off from the West.

"The world is not doing enough," Egeland told reporters Thursday.

Egeland said he was pleased with the response of the North Atlantic Treaty Organization (search) so far, but that he had been telling NATO officials they need to do more — "think bold, think big" — in building up its involvement.

NATO has said it lacks the light helicopters that are needed in Pakistan, but the alliance on Wednesday started its biggest ever joint airlift with the U.N. High Commissioner for Refugees (search) to get supplies into Pakistan, UNHCR spokesman Ron Redmond said.

The first three flights in the airlift, from Turkey to Pakistan, carried more than 28 tons of tents, blankets and stoves.

On Wednesday, U.N. Secretary-General Kofi Annan (search) warned that a second "massive wave of death" will quake-hit Pakistani areas most affected by the mammoth earthquake unless the international community immediately escalates the relief effort.

"This is a huge, huge disaster," Annan said. "It is a race against time to save the lives of these people. And I would hope that the international community will respond and those with capacity will do everything possible to work with us and work with the Pakistani government."

He said "an estimated 3 million men, women and children are homeless," and many of these people have not blankets or tents to protect them against the Himalayan winter.

Egeland said U.N. relief resources are depleted last year's Indian Ocean tsunami and recent disasters.

"The coffers are empty," he said.

He said that only $86 million had been pledged so far to the U.N. appeal for $312 million in donations for the quake victims.

A relief official, Lt. Gen. Mohammed Zubair, said Pakistan will complete its damage assessment by Nov. 15, and will launch its first phase of rebuilding homes, schools, hospitals and infrastructure.

The WHO said there have been 17 cases of tetanus in the quake-stricken area, three of them resulting in deaths in Balakot.

Senior surveillance officer Sarfaraz Tan Afridi, leader of the WHO team in North West Frontier Province, said his group was trying to immunize as many people as possible.

Tetanus is a bacterial infection that can cause fever, high blood pressure and severe muscle contractions. It can lead to the "locking" of the jaw, general stiffness, and death, especially among the elderly. People are infected when the bacteria, found in the ground and feces, enter through cuts and scratches.