Two mothers from the UK who died of herpes shortly after giving birth may have been infected with the virus by the same surgeon, a new investigation has suggested.
Kimberley Sampson, 29, and Samantha Mulcahy, 32, both died from the infection shortly after the same doctor performed Caesarean sections in 2018, according to an in-depth report by the BBC. The families of the women were initially told there was no connection between the deaths, but the new revelations suggest there may be a connection.
Both women died from an infection caused by herpes simplex type 1, aka HSV-1, one of two strains of the herpes simplex virus. Dying from HSV-1 is almost unheard of in healthy people. In fact, up to 67 percent of the global population under 50 are infected with HSV-1. Most cases are asymptomatic, but some cases present as painful blisters or ulcers at the site of infection. However, medical records showed these two women had not previously been infected with herpes, so they would have had no antibodies against the virus. Their immune system was also compromised because of their pregnancy.
Kimberley went into labor on 3 May 2018 at the Queen Elizabeth the Queen Mother Hospital in Margate, part of the East Kent Hospitals Trust. After it was decided her labor was not progressing quickly enough, doctors decided to perform a Caesarean. Her son was born and she was discharged from the hospital two days later, despite being in considerable pain. Her condition rapidly deteriorated and she rushed back to the hospital days later experiencing immense pain. Doctors initially couldn’t identify her condition, but they eventually diagnosed her with a catastrophic herpes infection. She died on May 22.
Samantha went into labor in early July 2018 at the William Harvey Hospital in Ashford, also part of the East Kent Hospitals Trust. After some “worrying blood test results,” she was taken for a C-section and her daughter was successfully delivered. However, the mother’s condition began to deteriorate over the next few days, experiencing a swollen stomach, a fever, and raised blood pressure. Doctors suspected Samantha was suffering from bacterial sepsis, so she was given antibiotics and not antiviral medication. Eventually, her organs began to shut down and she was taken to intensive care. Four days later, she died. The post-mortem investigation found Samantha had died from multi-organ failure following a "disseminated herpes simplex type 1 infection."
Emails seen by the BBC show that both women received the C-sections from the same midwife and surgeon. Another email from a micropathologists also indicates that the women were infected with strains of HSV-1 that are “probably the same,” indicating they may have come from the same source. It’s also noteworthy that this strain is relatively rare to the others in circulation in the UK.
The BBC spoke to Peter Greenhouse, an experienced consultant in sexual health with an interest in the herpes viruses, who described the case as "very unusual - very rare indeed." While he believes it is almost impossible to say with absolute certainty how this unlikely situation unfolded, he has a theory: the surgeon may have had a scarcely noticeable herpes infection on their finger, which could have "directly seeded the herpes into the abdomen of the women" during the operation. The surgeon would have been wearing gloves, but it’s possible for this protective equipment to split during c-sections.
In light of the new revelations, the families of the two women have been calling for a coroner to open fresh inquests into the deaths.
In a statement, the East Kent Hospitals Trust says the surgeon had verbally reported they had no history of herpes infection and had no hand lesions, although they were not tested for the virus at the time of the operations.
"East Kent Hospitals sought specialist support from Public Health England (PHE) following the tragic deaths of Kimberley and Samantha in 2018. The investigations led by the Trust and the Healthcare Safety Investigation Branch took advice from a number of experts and concluded that it was not possible to identify the source of either infection,” the statement added.
"Kimberley and Samantha's treatment was based on the different symptoms showed during their illness. Our thoughts are with their families, and we will do all we can to answer their concerns."