China and Hong Kong reported 10 new deaths today from severe acute respiratory syndrome and Premier Wen Jiabao described the disease for the first time as a "grave" crisis that continues to spread.

After chairing a special cabinet meeting on the sometimes-fatal illness on Sunday, Wen warned that the country's economy, international image and social stability could be affected.

"Much progress has been made in combating the disease . . . but the overall situation remains grave," Wen told the special session of the council.

Wen's statement, reported by the official New China News Agency and published throughout the country, marked a change in the government's tone in discussing the disease. In past weeks, Chinese officials had generally claimed that SARS, the acronym by which the illness is commonly known, was under control.

Health officials said SARS was spreading in the interior and expressed concern that the health care system in poorer parts of the country would be unable to cope with it. Shanxi province, west of Beijing, today reported three deaths and 47 more cases, from an original base of 32 infected and two dead.

SARS is believed to have originated in southern China in November and has since spread to at least 20 countries, killing 144 people and infecting more than 3,100. China has been the hardest hit, with 63 dead. The outbreak is also serious in Hong Kong, the former British colony reunited with China in 1997.

Officials in Hong Kong said seven more people had died from the disease, the highest number reported in a single day since the outbreak erupted early in March. An additional 40 people were infected, bringing the total to 1,190, the government said. Hong Kong's hospital chief reported four new cases among health care workers in the territory and said he would not rule out asking Beijing to send doctors to help fight the disease.

"We hope to use our own people first. But we don't rule out that we may have to ask others [from mainland China] to help if our situation worsens," Leong Che-hung, the hospital authority's chairman, told reporters. "Actually we are buying a lot of things like masks and surgical gowns from mainland China."

Tung Chee-hwa, Hong Kong's chief executive, told Chinese President Hu Jintao at a little-publicized meeting in Shenzhen last week that the territory had not been able to bring the disease under control. Previously, Tung had said that Hong Kong was successfully combating the disease. Hong Kong physicians and nurses said they feared a shortage of personnel if more medical workers became infected. Health experts have said there are not enough intensive care beds or isolation wards in Hong Kong, a condition that could lead to further infections.

The meeting between Tung and Hu last week was another sign of a change in Beijing's attitude toward SARS. International health officials have criticized the government for a delayed and weak reaction to the epidemic. Concern has spread among Chinese citizens that the government was not providing information on preventing the outbreak.

Researchers with the World Health Organization (WHO) continued to have problems dealing with the government, officials said. A source close to the WHO said there were weekend negotiations with authorities over permission to visit several military hospitals in the capital where there are unreported SARS cases. The WHO team said it hoped to visit the hospitals on Tuesday, the source said.

"The team was very straight with the Chinese," the source said. "They said, 'You guys have got a lot to lose. It's not us who is going to look bad.' " As a result, he said, the team was hopeful that access would be granted.

There have been persistent reports that Beijing military hospitals are treating a large number of cases that have not been listed by the Health Ministry. In the Communist Party structure, the military outranks the Health Ministry and can function independently. The former director of the military's No. 301 hospital, Jiang Yanyong, reported that there were more than 120 SARS cases at Beijing's military hospitals, while the government acknowledged only 22 in all of Beijing.

Sources in Shanxi province said the disease was detected there in February, reportedly transmitted by a 26-year-old woman returning from Guangdong on business. Officials in Guangdong were aware of the SARS outbreak, but did not report the disease to health authorities in Hong Kong or other provinces.

When the woman returned to Shanxi, she infected both of her parents and health workers at several hospitals. The unidentified woman later took her parents to Beijing for treatment, but both died in early March. The woman is believed to have recovered.

Today, officials in Shanxi said the province's local Center for Disease Control was instructed only last week to deal with SARS on an urgent basis. Only three hospitals in the province, all in the capital, Taiyuan, are able to handle SARS patients, officials said.

Pedestrians wear masks on a crowded street in Guangzhou, in southern China, where severe acute respiratory syndrome, which has spread rapidly, was first reported.