KENOSHA, Wis. — When it came time for the sign of peace ritual during Sunday Mass at St. Mary Catholic Church in southeastern Wisconsin, hundreds of parishioners did exactly what their pastor had asked.

Instead of reaching across the pews to shake hands, they greeted each other with gentle bows.

Fear of the coronavirus has rippled across the country and directly into places of worship. Religious leaders, mindful that cases have been discovered in at least 14 states so far, have begun taking measures that could discourage the spread of the virus in the large groups common in churches, synagogues and mosques.

They have asked congregants to change some familiar practices: Please stop holding the hand of the person closest to you when it is time to recite the Lord’s Prayer in church. When you walk into synagogue and greet your friends, don’t do it with a hug or kiss on the cheek. Definitely don’t shake hands.

Communal cups used during communion have been whisked away, placed in storage until the threat of coronavirus has passed. Church employees have placed hand sanitizer bottles in every pew. At one church in St. Paul, Minnesota, a minister dispensed a pump of Purell into everyone’s palm as they lined up for communion.

In an email titled “Special Message Regarding Coronavirus,” the Temple De Hirsch Sinai synagogue in Seattle outlined some precautions to its members.

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“As members of a warm and nurturing community, Temple members frequently greet each other with hugs and kisses,” the message said. “At this time, we recommend that an ‘elbow bump’ may be a more appropriate way of offering a warm welcome while also staying healthy.”

Public health officials are still scrambling to understand the new coronavirus that has spread across the globe in the past several months, but they have so far concluded that it is highly infectious and poses a particular risk to older people.

That has made large public gatherings especially fraught. Saudi Arabia has halted travel to certain holy sites for foreigners, and in Italy, home of the Catholic Church, many of the faithful watched Mass on television from home Sunday.

U.S. religious leaders said they were struggling to keep their members as safe from contagion as possible while still offering the usual comfort of gathering together to pray as a group.

Last week, the Rev. Roman Stikel, the pastor at St. Mary in Kenosha, decided to quickly make some temporary changes at his church. He sent robocalls to his parishioners warning them not to shake hands, and he is already mulling the idea of canceling Mass if the outbreak becomes a widespread emergency.

“For people who are very committed to coming to Mass and praying together as a community, this is going to be difficult for them,” he said. “What we’ll hope and pray for is that this is something that will pass.”

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By Monday afternoon, there were 100 confirmed cases of coronavirus in the United States, with the death toll rising to six. Most of the cases were in Washington state, California and Texas, including Americans who are under quarantine after being repatriated from China.

More on the COVID-19 pandemic

As concerns about coronavirus spread, Jennifer Baskerville-Burrows, the Episcopal bishop of Indianapolis, sent her members a note Friday announcing changes to worship, including the switch from ceramic chalices to metal in an effort to limit the spread of germs.

“It’s all about education and trying to help, both putting people at ease and giving them what they need to make good decisions about their well-being,” Bishop Baskerville-Burrows said in an interview.

Lev Gerstle, a graduate student at the University of Hawaii at Manoa in Honolulu, noticed that the “Shabbat shalom” greetings after the opening prayers at Temple Emanuel-El were a bit more subdued than usual.

“The rabbi made it clear that the shaking hands was maybe not a good idea,” he said.

At St. Michael’s Episcopal Church in Brattleboro, Vermont, the Rev. Mary Lindquist made a point of telling worshippers Sunday that she was sanitizing her hands before distributing communion. Fewer people opted for wine, she said.

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“I’ve been ordained for 20 years. I’ve never encountered anything quite like this before,” she said. “It’s amazing how rapidly it’s changed from last week to this week.”

If the situation worsens considerably and public gatherings become unsafe, St. Michael’s could opt to have services by webcast. But Lindquist was hoping it would not get to that point.

“Part of what makes church wonderful and special,” she said, “is just gathering with other people in one place.”

Over the weekend, the Rev. Matt Paul, pastor of First Presbyterian Church of Port Angeles, Washington, incorporated the coronavirus into his sermon. On Monday, when several more infections were announced in his state, he said he was counting on scientists to develop a vaccine but also believed that saving lives was “something only God can do.”

“Just the act of being together to worship is somewhat an act of faith and an act of risk,” he said. “We’re reminded of our humanity and the frailty of life.”

Stikel, in Wisconsin, said he has received only positive feedback from parishioners. Now he is thinking about what more he could do and has been eyeing the vat of holy water that churchgoers traditionally dip their fingers into every time they enter and exit the church.

“I might have to put Saran Wrap over that to cover it up,” he said. “That’s the next step.”

(Anika Varty / The Seattle Times)