With four Indonesian deaths already confirmed in two months, and mounting international concern that bird flu could mutate into a major killer of humans, Health Minister Siti Fadilah Supari warned of more infections ahead.

"This can be classified as an epidemic and most definitely there will be others as long as we are unable to positively identify the sources," Supari said on Wednesday.

A strain of bird flu known as H5N1 has killed 63 people in Southeast Asia since 2003, the majority of them in Vietnam.

Health experts say a major and quick-spreading pandemic could kill millions internationally.

The World Health Organisation's biggest fear is that H5N1 may mutate, acquiring genes from the human influenza virus that would make it highly infectious as well as lethal.

"It's obvious that a pandemic will occur, all the conditions are in place," WHO Director-General Lee Jong-wook said on Monday. "The problem now is time."

A team of US officials are in Indonesia to see how they can help Indonesia's efforts to curb bird flu, US embassy spokesman Max Kwak said.

The five-person team from the Centres for Disease Control and other agencies arrived on Sunday and will leave on Saturday as part of a regional fact-finding mission.

Medication

Supari said Indonesia would receive this week 9000 more Tamiflu tablets to supplement the 3000 already available.

The WHO recommends stockpiling of Tamiflu, an antiviral medication which can stop flu if given quickly when symptoms develop.  

Officials are concerned that bird
flu could mutate and kill millions

The Indonesian government on Monday gave bird flu "extraordinary incident" priority status to focus attention on the outbreak in the archipelago nation.

"I do not want to wait for more deaths to take place," the health minister explained.

But The Jakarta Post said in an editorial that it remained to be seen how the "extraordinary" situation was dealt with on the ground.

The newspaper called for public information campaigns and questioned whether the government did enough to prevent the virus from taking hold when it first appeared two years ago.

"It should be clear that it is no longer the time for choosing between the interests of the poultry industry and those of the public at large," the daily said.

Victims

A five-year-old girl who died in hospital showing symptoms of bird flu may be the latest victim, said Sardikin Giriputro, deputy director of the Sulianti Saroso hospital for respiratory ailments.

"It's obvious that a pandemic will occur, all the conditions are in place"

Lee Jong-wook,
WHO director general

"The patient that was admitted [on Tuesday] has now died," he said.

Sardikin cautioned that the cause of death had not been confirmed.

The authorities announced on Friday that a 37-year-old Jakarta woman was Indonesia's fourth confirmed bird flu death.

Health officials have not revealed exactly what caused her death but Georg Petersen, WHO's Indonesia representative, said she lived in an area with many chickens, ducks and even a slaughterhouse.

A Jakarta father and his two daughters died of bird flu in July.

Difficulties

The government has said infected chicken droppings are suspected to have caused those deaths.

Sardikin said two more patients with symptoms of bird flu were being treated at his respiratory hospital, bringing the total to eight.

One of them, a nine-year-old girl, had visited Jakarta's Ragunan Zoo just before officials ordered it closed last Sunday because of a bird flu outbreak.

He said the other new patient, a 17-year-old girl, had been taking care of chickens and pigeons, some of which died.

Petersen said on Tuesday that the WHO was pleased with Indonesia's efforts while acknowledging the difficulties in a developing country of about 220 million.