Amid criticism over the world's response to the catastrophe and warnings that thousands of people could die from exposure as the brutal Himalayan winter sets in, the United Nations nearly doubled its aid appeal.

Annan urged donor countries attending an emergency conference in Geneva to give generously as they did last year in the wake of the deadly Indian Ocean tsunami.

"We saw this generosity at the time of the tsunami. We need it here too," Annan told reporters.

"We need the support of governments, private citizens, the private sector and anyone who can spare a euro, a pound or a dollar," he said.

"It is urgent and it is desperate."

The death toll rose to 54,000 Wednesday and the situation remains dire, with 3.3 million people still homeless, 800,000 without any shelter and only about three weeks left to reach them before they are cut off by snow.

"With the severe winter approaching in a few weeks, we are racing against time to save people and have asked them to come down from the highlands," Pakistani Interior Minister Aftab Sherpao told AFP.

Wretched survivors were shaken from their sleep Wednesday by four aftershocks measuring up to 5.2 on the Richter scale, the latest of more than 950 such shocks since the original 7.6 magnitude quake on October 8.

Experts warned that any aftershock with a magnitude of five or above could trigger landslides.

"The fear is that landslides will further hamper our operations," World Food Programme spokesman David Orr said in Muzaffarabad, the devastated capital of Pakistani Kashmir.

The spectre of disease also cast a pall over the quake zone when a man with a suspected case of highly contagious haemorrhagic fever was airlifted from the shattered Kashmiri town of Bagh.

"There is a suspected case, but it's not a reason for alarm or panic," World Health Organisation (WHO) official Rachel Lavy told AFP. "We have evacuated the individual from the area and will take tests."

Around five percent of patients in Bagh have bronchitis or pneumonia and more people will perish if immediate help does not arrive soon, according to the medical charity Medecins sans Frontieres (MSF - Doctors Without Borders).

"People will die of exposure, they will die of pneumonia. We can feel it in our toes," said the aid group's medical coordinator for Bagh, Marc Joolen, adding that he regretted the world's "lukewarm response" so far.

Donor nations were meeting in Geneva on Wednesday to try to boost funding after the UN said it had raised its flash appeal total from 312 million dollars to 549.6 million dollars.

UN officials say just 103 million dollars has been pledged to the appeal so far, although around 600 million dollars more has been donated or pledged bilaterally to Pakistan.

"While no one today could have had the power to prevent the earthquake from happening, we do have the power to stop the next wave: the deaths and despair caused by freezing temperatures and disease, by lack of shelter, food and water," Annan told the aid meeting.

"We need more resources to save two to three million lives," UN emergency relief coordinator Jan Egeland said.

"It is a deadline. This is a line of life or death for tens of thousands if not hundreds of thousands of people in the Himalayas."

The International Federation of Red Cross and Red Crescent Societies also doubled its quake appeal, to 117 million dollars.

Pakistan says it needs a further five billion dollars for rebuilding the country. Egeland said a reconstruction conference would be held in Islamabad on November 18.

The British aid charity Oxfam said Tuesday that rich countries were not giving enough for Pakistan, naming seven which have so far given nothing to the UN appeal -- Austria, Belgium, Finland, France, Greece, Portugal and Spain.

Meanwhile Indian Prime Minister Manmohan Singh said his country was not to blame for the delay in opening up the frontier dividing Kashmir to let relief flow to affected areas.

His comments came hours after India said Pakistani soldiers objected to the construction of a footbridge by Indian troops across the Line of Control.

A man from Pakistani Kashmir was also arrested by Indian troops after he crossed the de facto border to meet his relatives on the Indian side.

Officials from India -- where 1,300 died in the quake -- and Pakistan are due to meet in Islamabad on Friday to discuss their varying proposals to open up the frontier.

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