German Chancellor Angela Merkel’s attempt to shake hands with the country’s interior minister was rebuffed Monday amid growing fears of the coronavirus outbreak.

More than 89,000 individual cases of the virus have been cited worldwide since COVID-19 was first identified late last year.

More than 3,000 people – including at least six in the United States – have died from the illness.

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The latest figures show that Germany had at least 157 cases of coronavirus, increasing the alert level in the country from “low to moderate” to “moderate.”

On Monday, Merkel was attending a meeting with leaders of migrant associations at the chancellery in Berlin when she greeted Germany’s interior minister, Horst Seehofer, by offering her hand.

German Interior Minister Horst Seehofer refuses to shake the hand of German Chancellor Angela Merkel for hygienic reasons before a migration summit at the Chancellery in Berlin, Germany, March 2, 2020. REUTERS/Hannibal Hanschke TPX IMAGES OF THE DAY - RC2MBF9K74K1

German Interior Minister Horst Seehofer refuses to shake the hand of German Chancellor Angela Merkel for hygienic reasons before a migration summit at the Chancellery in Berlin, Germany, March 2, 2020. REUTERS/Hannibal Hanschke TPX IMAGES OF THE DAY - RC2MBF9K74K1

In photos and video of the exchange, Seehofer smiles at Merkel but keeps his hands to himself.

They both appear to laugh it off as Merkel throws her hand up in the air and then takes a seat.

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In Germany, the virus has reportedly spread to 10 of the country’s 16 states, with more than half of the confirmed cases in North Rhine-Westphalia. Germany’s most populous state emerged as a hotspot after an infected couple attended carnival celebrations there, infecting dozens of people.

Health experts have recommended avoiding handshakes as a way of preventing the spread of the novel coronavirus. Disinfectants, hand sanitizers and other protective products have sold out in many German shops.

The Associated Press contributed to this report.