New NEJM case report describing severe human illness caused by highly pathogenic avian influenza A -H5N1 in British Columbia Canada teenager with evidence of potential viral adaptation to humans.

13-year-old in BC went from mild flu symptoms to full-blown respiratory failure.

Discharged after fever and conjunctivitis.

She came back days later in critical condition: pneumonia, kidney failure, leukopenia, and thrombocytopenia.

"plasma exchange was performed daily from November 14 through November 16."

This is quite bad, and a dreadful harbinger: