From Recombinomics

Here's something interesting about the genetics of what is going on in Indonesia. I am not sure what it means but:

Familial clusters in Indonesia have been common. Almost all have a 5-10 day gap between the index case and family member. Recently a seven member cluster in North Sumatra was described. H5N1 has been confirmed in all but the index case, and six of the seven have died, This cluster, the largest to date, has fueled concern about increased efficiency of human-to-human transmission. This cluster may be extended because one of the family members (10M) developed symptoms later than the other family member, and now the father of that fatal case has been hospitalized.

The growth in the number and size of the clusters has focused attention on the sequences of the H5N1 isolated from the patients. However, sequences from only one of the human H5N1 isolates has been released. It has a novel cleavage site, RESRRKKR, that has not been reported in any of the publicly available bird sequences from Indonesia or elsewhere.

These data suggest that the majority of the reported humans cases in Indonesia have not been linked to an avian sequence. Most of the sequences human isolates have been from West Java, including various locations in Jakarta and suburbs. Some of the avian sequence also are from West Java (see below)

The lack of a connection with bird H5N1 sequences and the increasing size and number of human clusters has raised pandemic concerns.