Religious freedom and public health have clashed in New York following reports of Herpes disease resulting from a lack of care in performing a halakhic method of sucking a tiny amount of blood from the wound following circumcision.
The disease was reported in 11 babies during an 11-year period ending last December, according to the Centers for Disease Control and Prevention (CDC), which warned against the practice of oral suction practices by some “mohelim,” who perform circumcisions.
Herpes can be fatal to babies, and two babies – twins – died after suffering brain damage, the report stated.
The procedure is considered safe and is actually considered hygienic becaue the “mohel” is supposed to be very careful to wash his mouth with liquids that sterilize any germs before he performs the ritual.
The issue was raised in the New York Jewish community seven years ago when Mayor Michael Bloomberg asked rabbis not to practice the procedure, but others said there was no danger for the above reason.
The mohel involved who performed the circumcision on the twins was the same one who was the apparent cause of Herpes in another baby.
The mohel involved in the case of the HSV infection in the cases of the twins and a third case was tested and his blood was found to contain antidotes to HSV, although there was no conclusion that he actively shed the virus.
The number of HSV infections in the 3,564 babies in New York City who were circumcised with the practice of oral suction during one year is miniscule, but health officials said the risk of being exposed to Herpes is 3.4 times greater than for those who are circumcised without the procedure. The oral suction is known in Hebrew as "metzitzah b’peh".
CDC estimated that the risk of Herpes infection following the special procedure is 24.4 per 100,000 boys during the five-year-period ending last December.
“Circumcision is a surgical procedure that can transmit infection if not performed under sterile conditions,” according to CDC. It continued, “Oral contact with an open wound in a neonate risks transmission of HSV and other pathogens. Professionals advising parents and parents choosing Jewish ritual circumcision should be aware of this risk, and direct or genital suction should be avoided.”
New York City Health Commissioner Department said that several hospitals have agreed to distribute printed information describing the possible risks.
“There is no safe way to perform oral suction on any open wound in a newborn,” said New York City Health Commissioner Dr. Thomas Farley “Parents considering ritual Jewish circumcision need to know that circumcision should only be performed under sterile conditions, like any other procedures that create open cuts, whether by mohelim or medical professionals.”
Many, but not all, Rabbinic authorities permit suction with a tube in the religious community.