Over the course of the past week, the sudden emergence of a cluster of human H5N1 infections within an extended family in the Tanah Karo district of North Sumatra in Indonesia has elevated international concern, and raised serious questions about Indonesia’s ability to manage the disease. Indonesia has logged 31 human deaths from H5N1, and has confirmed 23 human cases during 2006 alone, more than any other country, including 20 deaths. While the cluster appears to be contained, the virus continues to plague the country’s poultry population, and has now been confirmed in 21 of its 33 provinces.