Quake-ravaged Pakistan is facing a second catastrophe and a new wave of deaths if the world does not come forward to help survivors of the Oct. 8 earthquake before winter sets in, a top U.N. humanitarian official said Wednesday.

The warning came as the United Nations (search) nearly doubled its appeal to donor nations gathering Wednesday in Geneva to raise money for victims of the temblor, which is believed to have killed nearly 80,000 people — most in the high Himalayan mountains of northern Pakistan.

"Catastrophe looms large," said Rashid Khalikov (search), the U.N. humanitarian coordinator in this destroyed city. "The danger is there that the loss of life would be very high if the required help does not reach them" before winter.

In Geneva, the head of the U.N. Office for the Coordination of Humanitarian Affairs (search) said millions of lives were at risk, an apparent reference to the 3.3 million people left homeless by the disaster.

"We need more resources to save 2 million to 3 million lives and we need much more resources in the next few days," Jan Egeland said hours before the donor meeting. The U.N. is now asking for USS$549.6 million, up from the US$312 million it initially called for.

Temperatures are already dipping below freezing in some areas of Pakistan's mountainous north, and the weather is expected to worsen in coming weeks, cutting off remote valleys where some 800,000 people are believed to lack any shelter whatsoever.

Aid workers have just five weeks to get six months' worth of food supplies into the most remote areas of Pakistan before they are cut off, according to the U.N. World Food Program.

"We are racing against time. We need to win the race before snow falls," said Simon Missiri, head of the Asia and Pacific operation of the International Federation of Red Cross and Red Crescent Societies (search).

Despite the fresh warnings, the United Nations has said it has received less than 30 percent of the US$312 million (euro261 million) it initially requested. Pakistan has said rebuilding the area will cost US$5 billion (euro4.2 billion).

On Tuesday, the European Union proposed that member nations come up with an additional US$96 million (euro80 million), on top of the US$16.3 million (euro13.6 million) already dispensed to Pakistan for emergency disaster release.

The donors meeting in Geneva comes as aftershocks continue to rattle the region. A magnitude-5.2 aftershock shook Islamabad, the northwestern city of Peshawar and the quake-hit town of Mansehra on Wednesday, but there were no immediate reports of injuries or damage.

Fear of the spread of disease is also very real.

In the quake-devastated town of Bagh, a town about 60 kilometers (40 miles) southwest of Muzaffarabad, a patient fell ill with a suspected case of hemorrhagic fever, an aid official said Wednesday.

Krist Teirlinck, of the aid group Medecins Sans Frontieres, or Doctors Without Borders, said the patient was in an isolation tent on the grounds of Bagh's destroyed district hospital, in case the fever was contagious.

He would give no details about the patient or symptoms. He also said it was unclear if the earthquake had played any role in the illness.

Hemorrhagic fevers, which include such illnesses as Ebola and Marburg, are characterized by a sudden onset, fever, aching, bleeding in internal organs and shock. Earlier, several dozen quake victims came down with tetanus — or lockjaw — and at least three of them died.

In Muzaffarabad on Wednesday, the prime minister of Pakistan's portion of Kashmir, Sikandar Hayat Khan, urged India to accept President Gen. Pervez Musharraf's proposals for opening up the so-called Line of Control that divides Kashmir (search) between India and Pakistan.

The two nations have dueling proposals to bring help to quake victims living along the line.

"The proposal was not for any military purpose but totally for humanitarian help," Khan said at a ceremony where he gave compensation payments to relatives of those who died in the quake. Families are given 100,000 rupees (about $1,700) for each person who died.

Pakistan's government raised the official death toll to 54,197 on Wednesday, with another 78,000 injured. Central government figures have consistently lagged behind those by local officials, which put the death toll in Pakistan at about 78,000. A further 1,350 people died in Indian-held Kashmir.