January 5, 2015
Circumcision Ritual Infecting Infants With Herpes

Another New York infant has contracted herpes from an ultra-Orthodox Jewish practice known as metzitzah b'peh following a ritual circumcision known as brit milah. The practice involves using oral suction to clean the circumcision wound. If the mohel performing the ritual has oral herpes, it can be passed to the infant and can prove fatal.

Circumcision is a common practice among a few religions, but only the ultra-Orthodox Jews engage in this further ritual that exposes the circumcision wound to the unhygenic oral contact. Estimates put the number of post circumcision oral suction cleanings performed at around 3,600 per year in New York City.

New York rabbis are vehemently protesting the conclusions of the health department, claiming there is no proof that the circumcision or metzizah b'peh caused the infection. The pathogenesis of the herpes infection identified by the doctors who diagnosed and treated the infant argues against the rabbis. The timeline is consistent with the post circumcision ritual being to blame for the potentially fatal infection.

Since 2000, seventeen infants have been diagnosed with herpes following the circumcision ritual. Two of those infants died. Two more are permanently brain damaged. It is hypothesized that there may be more cases that were undiagnosed, or who have never presented for treatment.

Hasidic Jews are those most likely to engage in the controversial circumcision practice, and that subset of the population is very politically active, making legal intervention into this issue a contentious issue. Mayors Bloomberg and de Blasio have both pledged to address the problems with this circumcision ritual. Bloomberg enacted a regulation that required parents to be informed of the health risks to their newly circumcised baby, but this has proved nearly impossible to enforce. De Blasio made it a campaign issue, but thus far has not acted. Both politicos found balancing the needs of the infants with religious freedom to be a thorny problem.

Most Jewish people do not engage in the post circumcision ritual. Many more Jews are questioning circumcision altogether and are having brit shalom ceremonies in place of the brit milah, where no circumcision takes place. Circumcision rates are dropping across the U.S. in all populations despite the position of the AAP.

Circumcision is touted as helping to prevent certain STIs such as HIV, but the U.S. has one of the largest populations of circumcised males and one of the highest rates of HIV infections among industrialized nations. Other countries,whose medical professionals have much more experience in the care of uncircumcised individuals, claim that the U.S.'s stance is culturally biased and that the problems attributed to intact genitals are more likely caused by poor medical advice on how to clean, such as forcing premature retraction.

The public is becoming increasingly intolerant of the harm these circumcisions with the oral contact ritual are causing to these helpless infants. How do you think New York's mayor should address this contentious issue of circumcision, and the negative aspects while protecting religious freedoms?

[Image courtesy of the New York Times]