German authorities said on Friday that a nurse who treated a patient with swine flu has contracted the disease, the second confirmed case of person-to-person transmission in Europe.
The nurse in Bavaria, who has not recently been in Mexico, has now recovered, the health ministry said.
Germany's other three confirmed cases are in people who had recently been to Mexico, the epicentre of the outbreak.
Spain's 13 confirmed cases also include one person who had not recently travelled to Mexico and contracted the disease from his girlfriend, who had visited the country.
The Spanish government said Wednesday it was the first such case of human-to-human transmission of the disease in Spain.
Mexico has confirmed 12 deaths and 300 infections from the swine flu, a new flu strain that combines bird, swine and human influenza, but officials there have said the rapid course of the H1N1 virus could be slowing.
The World Health Organization (WHO) has warned that a global pandemic may be imminent. Its latest data on Friday showed 331 confirmed cases of infection in 11 countries. The only fatality outside Mexico is in the United States.