Gavin Joynt, professor of anaesthesia and intensive care at Chinese University Of all the cases he handled during the first bird flu outbreak and the Sars epidemic, the one that sticks in Gavin Joynt's mind is the futile battle to save a 13-year-old girl in 1997. Tse Man-si fought for her life in the intensive-care unit of Prince of Wales Hospital for two weeks before dying of multiple organ failure on December 21 of that year. It was one of the most difficult cases the medical professor had come across in 20 years as a doctor. 'It was a tough case because we had a young patient who had multiple organ diseases,' said Dr Joynt, who also treated 70 Sars cases in 2003. Dr Joynt said that although only six people died in the 1997 outbreak, compared with 299 during Sars, bird flu was the more deadly virus. 'The virus that we saw was a very nasty virus. Bird flu is different from Sars. One of the biggest differences is Sars mainly attacks the lung. Lungs are badly affected, but the damage to other things is mild. But bird flu tends to cause damage to different parts of the body: the lung, the kidneys, sometimes the brain, sometimes the liver. You can get multiple organ failure, making it more difficult to treat. 'Also, it is difficult to know what form the bird flu virus will take in terms of how it will affect us.' Recalling Tse Man-si's case, Dr Joynt said: 'She had breathing problems when she came to the intensive care unit (ICU). She had problems getting oxygen into her lungs. 'The patient was quite sick with other problems, not just the lungs. We used a machine to ventilate her lungs and gave her drugs to make her comfortable. 'You can imagine having plastic tubes and intravenous lines all over your body, which is very uncomfortable.' The teenager was the third victim to die of H5N1 flu in the outbreak. She had fallen ill first in November and was discharged on the 23rd of that month. Three days later, she returned to hospital and was transferred to the ICU the next night when her condition deteriorated. 'The patient presented typical flu-like symptoms: high fever, headache and muscle pain.' The medical team had given her an antiviral agent but the drug did not work. 'One of the big problems with viral infections is that there are few drugs which can help to directly treat the disease.' Whether patients survived a future bird flu outbreak 'in many ways would be out of doctors' control' as it depended more on the severity of the disease than on what doctors could offer. Another concern is that the limited number of intensive-care beds might not be enough to handle a large number of cases. But the medical professor gave an assurance that his team would do their best to treat patients, as they did during the 2003 Sars outbreak. 'I have complete confidence in the hospital staff. When it comes, we will deal with it, like with Sars.' He also warned people not to become too sensational about the current bird flu scare. 'I think people should have a balanced view of what may happen, and to know what to expect and what to do to make things better. 'The public should know that if bird flu does start to spread, they need to wear masks, wash hands, and to do all the measures. 'If the public understands how serious it can be, a virus which can damage or kill you, I think it will motivate them to do things correctly. 'On the other hand, it is not useful to sensationalise what could happen. Worst scenarios don't often happen. The outcome may be better than we expect.'