Herpes deaths: Caesareans unlikely source of herpes, inquest told

It is unlikely that two new mothers who died with herpes contracted the virus during their Caesarean deliveries, an inquest has been told.

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.

Consultant clinical scientist Michael Kidd said it was "very tricky" to say when the women had been infected.

He told the Maidstone hearing into their deaths: "It could have been before initial presentation. It could have been some time after that.

"My opinion is that it is unlikely to have occurred in the context of an operative procedure."

He suggested it is possible it was found "in the community, I cannot say where or at what stage".

The surgeon who operated on both women, and cannot be named for legal reasons, has previously told the hearing his hands were fully scrubbed, double gloved and he was wearing a mask during both procedures.

He also said he had no lesions and was not infected but had not been tested for the virus.

Dr Kidd said that "such individuals are very careful as to when they wear masks and gloves" and he felt it would take a "gross breach of professional precautions" to make spreading the virus to the patient possible.

On whether it was impossible or less likely the virus could have been spread by a droplet infection, Dr Kidd said "it would have needed large droplets" to spread an infection and "I think it would have been quite unlikely".

Ms Sampson's procedure took a maximum of two hours and 40 minutes while Ms Mulcahy's lasted for a total of 90 minutes.

Dr Kidd told the inquest: "That does not seem like a long exposure to me for a mask to become less efficient".

He said he thought it was "highly unlikely" that a surgeon who was wearing two pairs of gloves may have passed on the virus.

"But I would never say never," he added. "The surgeon has two gloves on and if he has never had any lesions or oral lesions, and he has given evidence on oath, then I would believe that."

Dr Kidd ruled out the instruments used during surgery, sexual transmission or blood transfusion as possible sources of the infection.

He said national guidelines of considering herpes when treating sepsis were "overdue".

On Thursday, 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 said: "Exposure at the time of surgery is unquestionably the most likely explanation."