Herpes deaths: Caesareans likely source of herpes, inquest told

Samantha Mulcahy (left) and Kimberley Sampson died weeks apart after being operated on by the same surgeon

The likely source of herpes infections in two mothers was during the surgical procedures to deliver their babies, an inquest has heard.

Kim Sampson, 29, and Samantha Mulcahy, 32, died in 2018 in hospitals run by the East Kent Hospitals NHS Trust.

The same obstetrician carried out their Caesareans seven weeks apart, the inquest has heard.

A herpes specialist said the chance they had picked up the virus before being admitted was "vanishingly small".

Ms Sampson died after giving birth at the Queen Elizabeth the Queen Mother Hospital (QEQM) in Margate, and Ms Mulcahy died at the William Harvey Hospital in Ashford.

Peter Greenhouse, a gynaecologist and venereologist with an expertise in the herpes virus, told the inquest the virus samples taken from both women were "exceptionally closely related but they were not identical".

He told the inquest in Maidstone there were very small differences in the viral genome which showed there had been no contamination of the samples.

He said: "Exposure at the time of surgery is unquestionably the most likely explanation."

Infection during surgery

Evidence from the post mortem, Mr Greenhouse added, indicated the herpes virus had been introduced into the abdomen rather than having spread through the body.

He said the mode of infection could have been through sweat and saliva, or the use of fingers during the surgery, but how it got into the abdomen he admitted was "pure conjecture".

Mr Greenhouse was told the surgeon gave evidence saying his hands were fully scrubbed and double gloved, that he was wearing a mask during the procedures and that he did not have a whitlow nor any history of the infection.

Mr Greenhouse responded: "The absence of any obvious signs or symptoms of herpes anywhere in this person's history or their own knowledge does not in any way exclude the possibility that they could have been exposed.

"Five out of six of the people in the courtroom will have been exposed to herpes."

Mr Greenhouse said the wearing of gloves and masks did not remove the possibility of infection.

He said Ms Sampson and Ms Mulcahy's cases were an "exceptionally rare and tragic scenario".

Infections 'very strange'

Professor Sebastian Lucas, the pathologist who performed post-mortem examinations for both women, said the droplet and whitlow hypotheses "could" account for infection but that there were "other possibilities" - including community acquisition.

He told the hearing he did not believe the infection had been sexually transmitted in either patient.

Asked whether the surgeon could have infected both women Prof Lucas said he found it "very strange" that someone could infect two different people 54 days apart.

He recorded the causes of death in both cases as liver and multi-organ failure and "disseminated [herpes] infection" acquired "before or around" the time of delivery.

The professor also included third trimester pregnancy in the causes of death as women can become immunocompromised during that time.

The inquest continues.

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