THE source of an infection which killed two mothers who died within 24 hours of each other after giving birth at the same Hampshire hospital remain a mystery, a coroner said today.
Mid-Hampshire coroner Grahame Short recorded verdicts of natural causes into the deaths of teachers Jasmine Pickett, 29, and Amy Kimmance, 39, who both gave birth at the Royal Hampshire County Hospital (RHCH) in Winchester on December 21, 2007.
But after they were both discharged, Mrs Kimmance, who gave birth to a girl, Tessa, died on December 23 and Mrs Pickett, of Colden Common, who gave birth to a boy, Christopher, died on December 24.
Mrs Kimmance developed fatal toxic shock syndrome as a result of a group A streptococcal infection and Mrs Pickett died from a sudden onset of severe pneumonia, likely to have been caused by a group A streptococcal infection.
Mr Short said the infection which killed Mrs Kimmance was unlikely to have been directly caught from a member of staff at the hospital but could have been indirectly caught from another patient, a visitor, a member of her family or someone in the local community.
He added that the source of the infection which killed Mrs Pickett was again unlikely to have been a member of staff but most likely to have come indirectly from another patient or visitor to the maternity unit.
The inquest was told that four days after Mrs Pickett's death, her husband David was tested positive for the streptococcal infection and the following day began to show deteriorating symptoms.
Dr Kevin Stewart, consultant of bacteria at the RHCH, said in a statement that when he examined Mr Pickett on December 29, he told him that he had been suffering from symptoms for a fortnight.
These symptoms included sore throat, muscle ache, fevers, lethargy and dry cough.
But Mr Pickett told the inquest that he had tested positive during the Christmas period and had only begun to feel unwell on December 27.
He also said that he had not experienced any symptoms prior to his wife's death.
The inquest was also told that the community midwife Christine Craze and hospital registrar Dr Emma Torbe both tested positive for the streptococcal infection several days after their deaths.
Dr Adnan Al-Badri, consultant pathologist, told the inquest that he found that Mrs Pickett died from multiple organ failure brought on by pneumonia caused by group A streptococcal infection.
He also told the inquest that Mrs Kimmance died of multiple organ failure caused by toxic shock syndrome from a group A streptococcal infection of the cervix.
Mr Short said he would write to the Health Protection Agency calling for national guidelines to be created for the management and investigation of group A streptococcus infections.
He said: "The deaths of both Jasmine Pickett and Amy Kimmance were devastating for their respective families.
"It is unusual these days for fit and healthy young women who have given birth to die within days of delivery.
"I find that both women died of the same strain of streptococcus which is a common bacterium found all around us in the community.
"I find it was particularly prevalent in this area in December 2007 which is often the case at the time of year.
"It was a particularly virulent strain that attacked both ladies and fortunately it is rare for the streptococcus to be quite so vehement."
Mr Short said: "When two women give birth at the same hospital within minutes of each other and both die within three days, it is natural for us all to question if this was more than just a coincidence and, quite properly, the Trust instigated a rigorous investigation.
"I would like to pay tribute to the staff at the Royal Hampshire County Hospital who cared for Amy Kimmance and Jasmine Pickett and the ambulance crew who did their very best to try to save these two women.
Mr Short added: "I would like to give my sympathy to both families, particularly to Mr Pickett and Mr Kimmance, both of whom have now to bring up their children without the love and support of a mother."
The inquest heard that Mrs Pickett, who gave birth by emergency Caesarean, was discharged from the Hampshire hospital on December 23.
The 29-year-old, originally from the Philippines, was suffering from a cough before leaving the hospital, which became worse on December 24 and she began coughing up blood.
Her husband David initially believed she was suffering an asthma attack but after several phone calls to her GP, arrangements were made for her to be readmitted to hospital.
But as Mr Pickett was dressing his wife, she collapsed and an emergency ambulance was called to take her to the hospital, where she died.
The hospital ran blood tests which identified blood poisoning caused by the streptococcal infection.
But her condition worsened during the day and staff at the hospital were unable to save her.
Speaking after the inquest, John Kimmance called for guidelines to be implemented nationally for the identification and management of streptococcus infection.
He said: "I now have a better understanding of what happened to Amy, which will help me to explain to my three children how and why Amy died when they ask, as they do and continue to do.
"We will never know how it was Amy came to be infected with group A streptococcus.
"But having heard there was a raised level of streptococcus A in this area at the time gives me some closure on that issue."
A statement read by solicitor Claire Fazan on behalf of Mr Pickett said: "David is preparing himself for answering Christopher's questions about how and why his mother died."
Mr Pickett also called for more information to be provided to new parents on the dangers of infection upon release from hospital.