KUALA LUMPUR, Nov 27 – A 61-year-old male patient was bitten by a rat in a medical ward at Raja Permaisuri Bainun Hospital (HRPB) last September, likely the first reported rat-bite case at a Malaysian hospital in recent history.
In the incident at the Ipoh general hospital in the state capital of Perak, the patient complained that a rat bit the palm of his left hand while he was on his hospital bed in Ward 5B on the night of September 6.
“The rat was very big; in his own words, ‘as big as a rabbit’,” an HRPB staff member told CodeBlue recently on condition of anonymity, as they were not authorised to speak to the press.
“There has been a rat infestation in the old main tower block for a few years until this incident.
“For your information, this is a global issue. Rat infestations in hospitals were reported in other countries too, including in the UK’s NHS, but rats biting patients is extremely rare and shows a total lack of awareness and ignorance on the part of the staff. Rat bite disease can be fatal.”
The patient’s daughter lodged a complaint with the Ministry of Health (MOH) after her father was discharged from HRPB last September 8, following early treatment for the rat bite.
She said in her written complaint, as sighted by CodeBlue, “My dad was bitten by a rat while he was in hospital. I hope you will take this situation seriously. Because this is a hospital, not a restaurant.”
The anonymous HRPB staff member claimed that members of the general public who stay overnight in the MOH hospital’s wards to look after their sick family members have seen rats crawling around and that these rodents infesting HRPB – as seen by both visitors and staff – are bigger than the usual domestic rats.
“The infestation was noted in many wards, especially in the outside front ward corridors. Broken things left over there for years. Staff don’t bother about public complaints, hence the delay in dealing with this issue which has been going on for several years until this rat-bite incident,” the HRPB staff member alleged to CodeBlue.
“Even security guards have seen rats running around in lobbies at night. The leftover food disposal method in ward also caused the rat infestations.
“Most patients don’t eat the tasteless GH food, especially morning breakfast, so it’s all left over around the patient’s bed without proper disposal. Food containers from GH kitchen and patients’ outside food all not properly stored in ward. All open for feast for the rats.”
The HRPB staff member also raised concern on whether very ill patients in acute and other cubicles in the wards – who mostly have reduced consciousness or are sedated with medication – may have been unknowingly bitten by rats for some time prior to the September 6 incident.
“It’s very hard to pick up unless it’s directly reported by the patients or there’s evidence like bleeding. In the Sept 6 case, the patient’s hand bled for sometime after the bite as the mark was deep,” said the staff member.
“The visitors who stay overnight complained they saw rats, mostly in the middle corridors and in the acute cubicle. Those unconscious patients won’t be able to defend themselves or react to the bites, especially when the lights are off at night in most cubicles, except at the nursing counters.”
According to the United States’ Centers for Disease Control and Prevention (CDC), rat-bite fever can cause severe infections and death without early diagnosis and appropriate treatment.
In two cases at two different hospitals in India, two patients bitten by rats in the intensive care units (ICU) of Rajawadi Hospital in Mumbai and MGM Hospital in Telangana, Hyderabad, in 2021 and 2022 respectively had died.
In the 2022 case, where the 38-year-old male patient had reportedly been left bleeding by rats inside the respiratory ICU, the respiratory ICU head of department had been suspended and the hospital superintendent transferred.
Tuanku Ja’afar Hospital in Seremban, Negeri Sembilan, reportedly had a rat infestation last year, with a video showing a rat running around in a ward at the government hospital.
“Do you know rats can also cause fire incidents? They bite into electric cables,” the HRPB staff member told CodeBlue, citing a previous incident in the same Ward 5B, where the rat-bite incident occurred last September, that saw a minor fire outbreak in 2016 due to an electrical wiring problem.
Ward Head Reprimanded During Rat-Bite Probe, HRPB’s Public Health Unit Now Conducts Monthly Spot Checks
The Perak state health department (JKN) said upon discharge from HRPB last September 8, the patient was given a letter of referral to visit a public health clinic near his home within two weeks for follow-up treatment for the rat bite and a repeat of blood sampling.
HRPB also conducted an investigation last September 8 into the rat-bite incident, finding that food waste management in the affected ward needed to be improved. The patient’s food was exposed and not properly covered.
The food was also placed on top of the cabinet, besides the patient’s habit of hanging plastic bags containing beverages in the ward, according to JKN Perak.
“The ward head was present during the investigation and was reprimanded about food waste management and the ward’s overall cleanliness,” Perak state health director Dr Sirajuddin Hashim said in a statement to CodeBlue, when asked about the rat-bite case at HRPB.
He listed several preventive measures taken by the public hospital following the rat-bite incident, including periodic checks on cleanliness and food management every week to ensure that wards are always clean, as well as spot checks by HRPB’s public health unit together with the concessionaire company every month for rodent control.
“All rat passageways have been closed and rat hideouts cleared.”
Dr Sirajuddin also said patients need to be briefed about the need to maintain personal hygiene and food management while in the wards.
The Perak state health department added that HRPB acknowledged last September 11 receiving the patient’s daughter’s complaint and that the case was closed on September 12.
“The complainant received HRPB management’s explanation well,” said Dr Sirajuddin.
When asked how HRPB’s rat infestation problem could be allowed to deteriorate until a rat bit a patient, Dr Sirajuddin cited the need for patients to cooperate in maintaining personal hygiene, as well as monitoring from hospital management on HRPB’s entire premises.
“HRPB took proactive action in handling this isolated incident.”
Dr Sirajuddin also said the Ipoh general hospital does not have an insect infestation problem, citing periodic checks in the MOH hospital, contradicting an HRPB staff member who claimed to CodeBlue that ants are “our permanent residents in the entire hospital; from time to time, you can see it on patients, their beds, and their things”.
The Perak state health department said it has not received complaints of rat infestations in other government hospitals in the northern state.
“JKN has instructed the public health unit in each hospital to monitor cleanliness and the safety of patients and staff in their respective hospital through periodic checks and audits.”
