H5N1 outbreaks in Indonesia were initially detected in poultry farms in December 2003 [7] . It was suggested that the H5N1 virus was first introduced to Java and subsequently spread to other parts of the country [8] . The virus rapidly became endemic in Indonesia [9, 10] , and continued to cause sporadic zoonotic transmissions to humans beginning in July 2005 [9] . Three clusters of H5N1 transmission among family members were identified in 2005, raising concerns of possible human-to-human transmission of the virus [11, 12] . As of April 8, 2008 , Indonesia had 132 confirmed human cases with 107 deaths [13] , the largest number of deaths among all affected countries.