In 2005, 98 human cases with 43 mortalities were reported from Cambodia, China, Indonesia, Thailand and Vietnam. Again all these outbreaks were associated with an ongoing H5N1 infection in poultry. The next year the cases and geographical area increased and 115 cases with 79 deaths were reported from China, Cambodia, Azerbaijan, Djibouti, Egypt, Indonesia, Iraq, Thailand and Turkey. Most of these were again from contact with dead or live infected poultry. The only evidence of human to human transmission was in a family cluster of 8 in Indonesia in which 7 individuals died [1].