Two mothers’ deaths from Herpes: what the inquest found

Kimberley Sampson and Samantha Mulcahy both gave birth by caesarean section in 2018, in hospitals run by East Kent Hospitals University NHS Foundation Trust. Both became seriously ill after giving birth, and they died in May and July 2018 of disseminated Herpes simplex type 1, an infection that had spread through the body and caused their organs to fail.

The coroner found that both women caught the virus before or around the time they gave birth. Two members of staff had been involved in treating both women, but advice on testing staff was unclear, so neither was tested, and the inquest couldn’t establish that both women were infected from the same source.

Joint inquests ended in July 2023. The coroner found:

• Antiviral treatment for Kimberley was delayed, partly because she also had a bacterial infection, and because her worsening liver function wasn’t linked to a viral infection quickly enough.
• Samantha was never given antiviral treatment, because her symptoms were unclear and a liver condition she’d had in pregnancy, obstetric cholestasis, complicated the picture.
• Earlier treatment with aciclovir, the antiviral medicine for Herpes, is likely to have significantly reduced the risk of death.

The coroner described this as a rare but often fatal disease around the time of birth, and noted that sepsis protocols covered antibiotics but not antiviral treatment.

In September 2023, the coroner sent a report to prevent future deaths to the Royal College of Obstetricians and Gynaecologists (RCOG) and NHS England. Since then:

• In December 2023, NHS England told the coroner that the trust had added information about Herpes to its leaflets for new mothers, introduced a new pathway to help diagnose Herpes early, and reviewed its infection control.
• In 2024, updated UK guidelines on Herpes in pregnancy told doctors to consider disseminated Herpes in any unwell pregnant woman or new mother with a sepsis-like illness or worsening liver tests, and to start high-dose aciclovir urgently, before test results come back.
• In December 2024, the RCOG published new guidance on sepsis during and after pregnancy.

It’s rare. UK guidelines say disseminated Herpes is rare in adults, but it has been reported more often in pregnancy, and the risk of death is high. It can appear in pregnancy or in the days after birth as Hepatitis, inflammation of the brain, widespread sores or a sepsis-like illness.

Babies can be affected too. Neonatal Herpes affects around 7 in every 100,000 newborn babies in the UK. It can be very serious, especially if it spreads to the baby’s organs, but quick treatment improves the outcome.

Most women who had genital Herpes before pregnancy have a healthy baby and a vaginal birth. The risk to the baby is highest if you catch Herpes for the first time late in pregnancy. The NHS and UK guidelines say:

• If you’ve had genital Herpes, or think you have it now, tell your midwife or doctor.
• You’ll usually be offered antiviral medicine from around 32 weeks of pregnancy to lower the risk of an outbreak during labour.
• If you have a first outbreak in the last 3 months of pregnancy, a caesarean is recommended.
• Anyone with a cold sore should never kiss a newborn baby.

Having given birth in the last 6 weeks also raises your risk of sepsis. Call 999 if you or a new mother you’re with is breathing very fast, is confused, has blue, pale or blotchy skin, has a very high or very low temperature, has a rash that doesn’t fade when you press it, or has symptoms you’re worried might be sepsis.

Herpes is very easy to pass on from the first tingle of an outbreak until the sores have fully healed, and it can also pass on when there are no symptoms. You can catch it through skin-to-skin contact, including vaginal, anal and oral sex, if a cold sore touches your genitals, and by sharing sex toys. You can’t catch it from towels, swimming pools or toilet seats.

Herpes simplex type 1, which causes cold sores, is now the most common cause of genital Herpes in the UK.

Very common:

• About 70% of people in the UK have a Herpes infection somewhere on their body by the age of 25, although many only ever have cold sores.
• WHO estimates that 3.8 billion people under 50 worldwide have Herpes simplex type 1, and 520 million people aged 15 to 49 have type 2.
• In England, diagnoses of first episode genital Herpes rose by 3.1% in 2025, while many other STIs fell.

If you have a sore or blister, a swab of the sore is the most accurate test. A blood test can show whether you’ve had Herpes 1 or Herpes 2 at some point, but it can’t tell you where on your body the infection is or who you got it from.

UK sexual health experts say the blood test isn’t very accurate, so it isn’t usually offered to people without symptoms. It can be useful in some situations, for example to check whether a first outbreak in pregnancy is a new infection. Read more in “How accurate are blood tests for Herpes?”

Better2Know offers:

• Herpes Simplex Type 1 and 2 (Swab): tests a swab from a sore on or around your mouth or genitals for Herpes 1 and Herpes 2, with results in 5 days. You can book it at one of our clinics or order it as a home test kit.
• Blemish Screen: if you have a sore, blister or lump on or around your genitals, it tests a swab for Herpes 1, Herpes 2, HPV and Syphilis, with results in 5 days.
• Herpes Simplex Type 1 and 2 (IgG): a blood test for antibodies to Herpes 1 and 2, from 28 days after possible exposure, with results in 2 days. It’s also available as a home test kit.

A Syphilis test in the first 3 months after sex can miss the infection, so you may need a repeat test. If you’re pregnant, tell your midwife about any sores or a history of Herpes as well. Not sure which test you need? Our Patient Care Team is available 24/7 on 020 7099 0955.

Can you get genital Herpes from a cold sore?

Yes. Cold sores are caused by the Herpes simplex virus, and oral sex with someone who has a cold sore can give you genital Herpes. Avoid kissing and oral sex until a cold sore has completely healed. Read more in “I got Herpes. How can I treat my cold sores?”

Can Herpes be cured?

No, but it can be managed. Antiviral medicine can shorten an outbreak by 1 or 2 days if you start it as soon as symptoms appear, and people with more than 6 outbreaks a year may benefit from taking it for 6 to 12 months.

Does Herpes raise your risk of HIV?

Yes. WHO says Herpes simplex type 2 raises the risk of getting HIV about three times. If you have Herpes, it’s a good idea to test for other STIs too.

Herpes is common and, for most people, mild. The deaths of two new mothers in 2018 were rare, but they led to better awareness and new guidance for doctors about Herpes around the time of birth. If you’re pregnant, tell your midwife about any history of Herpes, and get any new sore checked.

Book a Herpes swab test at a clinic near you or order a home test kit. Our Patient Care Team is available 24/7 on 020 7099 0955.

Not in the UK? Choose your country from the selector at the top of the page for local tests and prices.

This article originally appeared on 10 December 2021 and was last updated on 1 October 2026.

This article is general information and not a substitute for personal medical advice.

Sources

1. Courts and Tribunals Judiciary, Kimberley Sampson and Samantha Mulcahy: prevention of future deaths report, 17 September 2023. https://www.judiciary.uk/prevention-of-future-death-reports/kimberley-sampson-and-samantha-mulcahy-prevention-of-future-deaths-report/
2. Royal College of Obstetricians and Gynaecologists, Response to prevention of future deaths report 2023-0338, 10 November 2023. https://www.judiciary.uk/wp-content/uploads/2023/09/2023-0338-Response-from-Royal-College-of-Obstetricians-and-Gynaecologists.pdf
3. NHS England, Response to prevention of future deaths report 2023-0338, 11 December 2023. https://www.judiciary.uk/wp-content/uploads/2023/09/2023-0338-Response-from-NHS-England.pdf
4. Clarke E, Patel R, Dickins D, et al. Joint British Association for Sexual Health and HIV and Royal College of Obstetricians and Gynaecologists national UK guideline for the management of herpes simplex virus (HSV) in pregnancy and the neonate (2024 update). https://www.bashh.org/_userfiles/pages/files/clarkeetal2024jointbritishassociationforsexualhealthandhivandroyalcollegeofobstetriciansand.pdf
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6. Patel R, Green J, Moran B, et al. British Association of Sexual Health and HIV UK national guideline for the management of anogenital herpes, 2024. https://www.bashh.org/_userfiles/pages/files/pateletal2024britishassociationofsexualhealthandhivuknationalguidelineforthemanagementofanogenital.pdf
7. British Association for Sexual Health and HIV, Genital herpes: patient information leaflet, February 2026. https://www.bashh.org/_userfiles/pages/files/resources/herpes_pil_mobilepdf_04.pdf
8. British Association for Sexual Health and HIV, Genital herpes and pregnancy: patient information leaflet, March 2026. https://www.bashh.org/_userfiles/pages/files/genital_herpes_in_pregnancy_pil_mobile_version.pdf
9. NHS, Genital herpes, reviewed 27 June 2023. https://www.nhs.uk/conditions/genital-herpes/
10. NHS, Neonatal herpes, reviewed 24 July 2025. https://www.nhs.uk/conditions/neonatal-herpes/
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14. UK Health Security Agency, Sexually transmitted infections and screening for chlamydia in England: 2025 report, 2 June 2026. https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables/sexually-transmitted-infections-and-screening-for-chlamydia-in-england-2025-report
15. British Association for Sexual Health and HIV, UK guidelines for the management of syphilis, 2024. https://www.bashh.org/_userfiles/pages/files/syphilis_2024.pdf