In the period since Christmas, I have twice noted heavy and widespread cockroach infestation in and around the clinical waste storage area of large hospitals, and once more in the lean-to cupboard used for clinical wastes by a GP practice.

Fly infestation seems to be rare in the UK, though common in other climates, while cockroaches are almost universal in distribution.

There is experimental evidence to show that cockroaches can carry on them and in their gut a range of bacterial and viral pathogens, that they are remarkably resistant to chemical attack with liquid and gaseous disinfectants, and that they can spread infections from one area of the hospital to another.

Where hospital storage areas are infested, it is then easy for that infestation to spread to a treatment facility, and possibly back to another healthcare establishment. More than once I have observed heavy infestations at a clinical waste treatment facility, in that case imported via general commercial waste carts delivered – supposedly empty and clean – by a licenced general waste contractor. Inevitably, cockroaches  escaped the cart and spread throughout the facility, risking various complaints from neighbours and regulatory wrath,  but also substantially increased costs for additional pest control interventions and deep cleaning.

The usual pest control precautions should apply for all sites. Additionally, staff must be made aware and asked to report increased sightings that might indicate the need for an extra visit by the pest controller. Heavy and uncontrolled infestation may create problems elsewhere as the little blighters roam, and suggests significant deficiency in overall hygiene and management standards.