A rather disturbing NEJM case report to kick us off for 2025 – a previously healthy 13 year old girl with severe respiratory infection due to influenza A (H5N1) bird flu in Canada. The girl came through ECMO and survived. But it’s a salutary lesson of what influenza – and especially H5N1 influenza – can do! There’s a lot of flu around at the moment (of various types), so please get your flu vaccine if you haven’t done so already – it’s good for you and those around you if you do.