Stricter swine flu tests have cut the number of confirmed deaths in Mexico, where the virus was first reported, from 20 to seven, authorities say.
But officials warned the number of deaths likely to have been caused by swine flu has risen to 159 with more than 1,300 patients under observation.
The number of cases globally is rising though no-one outside Mexico has died.
Germany has become the latest country to confirm cases of the H1N1 virus, reporting three sufferers.
CONFIRMED & SUSPECTED CASESThe Robert Koch Institute, responsible for disease control and prevention, said a 22-year-old woman was in hospital in Hamburg and that a 37-year-old woman and a man in his late thirties were in separate hospitals in Bavaria.
All three recently returned from Mexico, officials said.
Spain and the UK earlier confirmed two cases each and six other EU states have been monitoring patients suspected of having the virus.
At 64, the US has the greatest number of confirmed cases outside Mexico. The state of California has declared a state of emergency and President Barack Obama is asking Congress for an additional $1.5bn dollars to bolster the US response.
A US federal health official, Dr Richard Besser of the Centers for Disease Control and Prevention, said on Tuesday: "As we continue to investigate cases here, I expect that we will see deaths in this country."
Canada, New Zealand and Israel have also detected the virus, and other states with suspected cases include Australia, South Korea and Peru.
Confusion
In Mexico, there is some confusion over exactly how many people died from H1N1, the BBC's Stephen Gibbs reports.
From Matthew Price in Oaxaca, Mexico
The first fatal case of the virus is believed to have been contracted here in Oaxaca. It is a tourist centre and the obvious concern is that when the visitors leave, they may take the virus with them.
At the local cemetery, a group of gravediggers pointed me towards a freshly dug plot. The flowers on top had wilted under the sun but still had some colour. Here was the grave of the first confirmed victim of the virus, Adela Gutierrez, 39.
One of the gravediggers, Sergio Castro Lopez, told me people here are worried. They are waiting for the authorities to tell them what they should do. I tried at the local hospital to get more information but the ministry of health has ordered its staff across the country to remain silent.
This is largely because the government is now subjecting the samples it has from deceased patients to a more laborious verification process.
Meanwhile, the search for the source of the outbreak continues, with the focus on the vicinity of a pig farm in the eastern part of the country.
The Mexican government is urging against jumping to conclusions and is suggesting the possibility remains that the virus originated outside the country, our correspondent adds.
The capital, Mexico City, has banned restaurants and cafes from serving all food except takeaways to try to prevent the spread of the virus.
Schools across the country have closed, public gatherings are restricted and archaeological sites have been placed off-limits.
Mexico City's chamber of trade estimated restrictions in the city were costing businesses there at least 777 million pesos ($57m or £39m) a day.
People have been cancelling beautician appointments, wary of close physical contact, Reuters news agency reports.
"The customers are scared stupid - they don't want to go out," said hairdresser Esther Gonzalez.
Experts meeting
The World Health Organisation has called a meeting of scientific experts for Wednesday to discuss the situation and the exact nature of the outbreak.
SYMPTOMS - WHAT TO DOEarlier, it confirmed that the flu was being transmitted between humans and called on countries to check their contingency plans for a possible pandemic.
But the WHO also urged caution, saying measures like travel bans were unlikely to prove effective.
Spain is one of the countries outside the Americas most vulnerable to the virus because of the sheer volume of its air passenger traffic with Mexico.
It has two confirmed cases of swine flu and a further 32 people are undergoing tests.
The government says the situation is "under control", that no lives are at risk and that there is no evidence of human-to-human transmission within Spain.
"There is great fear among the medical community... One of my colleagues that was exposed chose to stay in a hotel rather than run the risk of infecting her daughters"Instead, it says all those under observation fell ill after visiting Mexico.
All incoming passengers from that country and the US are being asked to fill in forms with medical information and contact details and airlines have been ordered to carry surgical masks.
With more than 30,000 passengers a month travelling from Mexico to Madrid, swine flu is a logistical challenge, the BBC's Steve Kingstone reports from the Spanish capital.
The authorities are preparing for the long haul, our correspondent says.
RELATED INTERNET LINKS
World Health Organization
Government of Mexico
US Centers for Disease Control and Prevention
Robert Koch institute
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