The European Union health commissioner on Monday urged Europeans to postpone nonessential travel to parts of the United States and Mexico affected by the swine flu, and holiday tour operators from Germany and Japan canceled charter flights to Mexico.

Spain became the first nation outside North America to confirm a case of swine flu Monday, and Scotland's health secretary announced that tests "conclusively" confirmed two cases there in people recently returned from Mexico.

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Related: Swine Flu Fears Close Schools Across U.S.

The World Health Organization expressed alarm about the disease's rapid spread and airline stocks sank on fears of a sharp drop in travel.

The number of confirmed swine flu cases worldwide rose to 73, WHO announced, saying it was "very concerned" and could decide within hours whether to raise its pandemic alert level. It said cases in the United States had doubled to 40.

Mexico had by far the most suspected swine flu cases — 1,614, including as many as 149 deaths — while Canada has six confirmed cases.

Russia, Hong Kong and Taiwan said visitors returning from flu-affected areas with fevers would be quarantined, while countries from New Zealand to Israel quickly instituted new security measures at airports and put sick travelers under observation.

Worried that the deadly outbreak could derail the global economy, investors sold airline and hotel stocks.

Travel agents scrambled to cancel their clients' Mexican vacations and switch them elsewhere. Russian agencies said 30 percent of those planning to travel to Mexico in early May had already canceled.

Many airlines, including American, United, Continental, US Airways, Mexicana and Air Canada, were waiving usual penalties for changing reservations for anyone traveling to, from, or through Mexico.

EU Health Commissioner Androulla Vassiliou toned down her earlier recommendation to avoid all nonessential travel to North America.

"I meant a travel advisory, not a travel ban, for travel to Mexico City and those states in the United States where we have outbreaks" of swine flu, the commissioner said.

President Barack Obama said Monday the threat of spreading swine flu infections was cause for concern but "not a cause for alarm," as the United States stepped up border monitoring.

At Germany's bustling Frankfurt Airport, people suspected of having the disease are being examined before getting off planes, according to the Hesse health minister, Juergen Banzer.

Germany's leading vacation tour operators were skipping stops to Mexico City as a precaution. The Hannover-based TUI said Monday that trips through May 4 to the Mexican capital were being suspended, including those operated by TUI itself and also through companies 1-2 Fly, Airtours, Berge & Meer, Grebeco and L'tur.

Japan's largest tour agency, JTB Corp., suspended tours to Mexico at least through June 30.

New Zealand was testing 13 students, parents and teachers who were showing flu-like symptoms after returning from Mexico. Britain, Israel, France, Switzerland and Sweden were also testing suspects.

WHO spokesman Paul Garwood said the organization has seen an increased number of confirmed cases in several countries.

"WHO is very concerned about the number of cases that are appearing, and the fact that more and more cases are appearing in different countries," he told The Associated Press in Geneva.

If the World Health Organization raises its pandemic alert level to 4 or 5, from the current 3, that signals the swine flu virus is becoming increasingly adept at spreading between humans. An alert level of 3 means there is an animal virus that occasionally causes human cases but doesn't spread well between people.

A raised alert could prompt WHO to issue travel advisories, warning against travel to regions battling outbreaks. Trade could be restricted, sports events and concerts could be canceled and borders could be closed.

Health officials insist it was safe to eat thoroughly cooked pork, but China, Russia and Ukraine banned imports of pork and pork products from Mexico and the three U.S. states which have reported cases of swine flu. Azerbaijan banned all livestock products from all of North America.

Spain's case of swine flu involved a university student who fell ill after returning from Mexico. Health Minister Trinidad Jimenez said another 20 sick people in Spain were under observation to determine if they have the disease, but she said none were in serious condition.

The student, from Almansa in the central Castilla-La Mancha region, checked in to a clinic Saturday complaining of fever and respiratory problems and was hospitalized.

At Madrid's Barajas International Airport, passengers arriving from Mexico on Monday had to fill out forms detailing where they had been, whether they had felt any cold symptoms and leave a contact address and phone number.

"Where we were (in Mexico), there was no real alarm but we followed what was happening on the news and we're a little bit worried," said Spaniard Filomeno Ruiz, just back from a week's holiday in Cancun.

Passengers were also given leaflets urging them to contact local health authorities if they noticed any symptoms in the next 10 days.

In the airport's baggage arrival area, ground crews and police wore blue or white surgical-type face masks. Some travelers took precautions even though they had not been to Mexico.

"Nobody has recommended it, but I've put the mask on out of precaution," said Briton Roger Holmes, who was traveling to Tunisia from Madrid. "I'm not afraid but it costs nothing to be careful."

Governments in Asia lept into action, scarred by potent memories of SARS and bird flu outbreaks.

Singapore, Thailand, Japan, Indonesia, and the Philippines dusted off thermal scanners used during the 2003 SARS crisis and were checking for signs of fever among passengers arriving at airports from North America. South Korea and Indonesia introduced similar screening.

In Malaysia, health workers wearing face masks took the temperatures of passengers at the airport as they arrived from Los Angeles.

All the suspected New Zealand students and teachers along with their families voluntarily quarantined themselves at home and those with flu symptoms were being treated with Tamiflu as a precaution.

Swiss drug company Roche Holding AG said it could deliver 5 million packages of Tamiflu anywhere in the world within 24 hours. Those WHO-controlled stockpiles are in addition to millions more treatments held by up to 90 governments.

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On the Net:

WHO swine flu page

CDC: www.cdc.gov