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The first cases of pneumonic plague outside this stricken western city were confirmed Tuesday hundreds of miles away in the capital, New Delhi, and across the subcontinent in Calcutta.

Since the disease broke out in Surat a week ago, at least 54 people have died, and unofficial estimates put the toll as high as 300. An estimated 400,000 residents who fled appear to be spreading it to rural areas of surrounding Gujarat state and elsewhere in this nation of 850 million people.Despite the appearance of new cases far from the initial outbreak, the U.N. health agency cautioned against panic and said it was too early to say India would suffer a nationwide epidemic.

Plague, a bacterial disease spread by fleas from infected rodents or contact with sick people, is curable with antibiotics. Authorities rushed medicine to affected areas. The outbreak is India's first in 30 years.

Many of the people who fled Surat last week went 160 miles south to Bombay, India's biggest city, but the first cases of pneumonic plague outside Surat were reported Tuesday in New Delhi, 730 miles northeast.

Twenty people, most of them from Surat, have been admitted to the Infectious Diseases Hospital in New Delhi. Two of them have tested positive for pneumonic plague, Dr. R.C. Panda said.

At the capital's train and bus stations, loudspeakers told arriving passengers with plague symptoms to report to doctors at the stations. Police were ordered to rush anyone with plague symptoms to the hospital.

In Calcutta, meanwhile, the West Bengal state government issued a "red alert" Tuesday night after seven of 17 patients admitted to hospitals in the state tested positive for pneumonic plague, United News of India reported.

Five of the plague patients were in Calcutta, which is 1,000 miles east of Surat, and one each were in the Malda and Midnapore districts outside the city, UNI said.

In Bombay, 10 suspected pneumonic plague patients were admitted to hospitals Tuesday, increasing the total to 42, health officials said. But tests had not confirmed any cases of plague yet.