The World Health Organisation confirmed six more human cases of bird flu infections in Indonesia today, including five deaths from the disease.
Four of the deaths occured in one family sparking fears of human-to-human transmission
"There are six confirmations. One from Surabaya and five from Medan. One from Medan is still alive," said Sari Setiogi, the WHO's Indonesia spokeswoman.
An outbreak of H5N1 bird flu involving up to eight members of the Medan family in North Sumatra province has worried health agencies around the world but a Health Ministry official said today it was not a case of human-to-human transmission.
"The spread was through risk factors from poultry or other animals. There is no proof of human to human," Nyoman Kandun, director-general of disease control, said.
"The world is watching us. We are not being hasty," he added. Four of the five family members have died and samples from a further three people believed to be part of the family cluster of infections are still being tested.
The WHO has sent a team to the area near Medan. The agency said it was on alert for signs the virus is mutating into one that can be easily transmitted between people, a development that could signal the start of a pandemic in which millions could die.
Such a mutation could occur anywhere there is bird flu, the WHO says.
Mr Kandun said authorities were still trying to identify the source of the virus in the cluster case in Kubu Simbelang village in Karo regency, about 50 km south of Medan.
But an Indonesian agriculture official who declined to be named said tests had shed no light on the case. "There is a big question mark. Blood samples from all kinds of animals from chickens, ducks, geese, birds, pigs, cats and dogs turned out negative so far. Manure has also been checked. The result is negative," the Jakarta-based official said.
The sixth of the cases confirmed today was a 38-year-old catering businesswoman from Surabaya who had dealt with live pigs and pork meat before she died last week.
The latest deaths bring the number of Indonesians who have died from bird flu to 30, by far the highest death rate in the world this year from the disease.
It has killed 115 people worldwide, the majority in east Asia, since reappearing in 2003. Virtually all the victims caught the disease from poultry.