While Health officials in Indonesia are still trying to track down the source of infection in a cluster of six deaths in one family from H5N1 bird flu, tests show that two more people have also died of the same disease.
One of the latest victims belonged to the same Sumatran family, which lost several members earlier this month to bird flu, raising the concern of human-to-human transmission.
I Nyoman Kandun, director-general of communicable disease control at the Indonesian health ministry says the man is the father of the child who died on May 13.
He apparently ran away after receiving a Tamiflu shot and was later found in the village but refused any further treatment.
Another death generally considered to be the initial case of the cluster in the village in north Sumatra, cannot be confirmed because no samples were obtained.
The woman died three weeks ago but health officials are no closer to finding the source of the virus despite quite vigorous testing of chickens, ducks and pigs in the neighbouring district as well as the immediate surrounding area.
Kandun said a 38-year-old man from Jakarta who died last week had also been declared positive for bird flu by local tests and at this stage human-to-human transmission cannot be conclusively confirmed or dismissed.
Experts with experience of getting people in such settings to co-operate with public health officials warn of the significant challenge facing health workers, requiring good communication with the community, sensitivity and an eagerness to understand the local situation.
Five of the man's relatives have been confirmed as dying from bird flu by the World Health Organisation (WHO) and another family member has survived the infection; it is not uncommon for people in such a situation to panic and fear intervention from outside agencies.
The WHO because of past experience with outbreaks such as the Ebola one, now often include medical anthropologists or psychologists on outbreak teams as "social mobilizers" who can bridge the divide between the people affected and medical experts.
Another problem may be convincing Indonesian villagers that H5N1 control necessitates the culling of affected poultry, often their only source of income and a vital food supply.
At this stage the movement of diseased poultry is suspected to have played a role in the events and supports repeated calls from experts for stronger measures to stem such movement.