City reports new case of herpes after metzitzah b’peh
The city's health department reported that another infant has been diagnosed with neonatal herpes following the Jewish circumcision ritual known as metzitzah b’peh.
There have now been four reported cases in 2014, and though Mayor Bill de Blasio promised to address the issue on "Day 1" of his term, there have been no policy changes during his first year in office.
Metzitzah b’peh involves a mohel sucking the blood directly from the wounded penis and has been roundly criticized by public health experts and by most authorities in the Jewish community.
While some in the Orthodox community contend this is the only acceptable way to perform a circumcision, or Brit Milah, many authorities condone squeezing the blood out or using sterile pipette to suction the blood, which decreases the chance of infection.
This is the 17th case since 2000, the health department said. Of those 17, two infants have died and at least two more have suffered brain damage.
The most recent case involved a boy born in November. Twelve days after his circumcision, the baby was brought to a pediatrician’s office because of concerns about fussiness after feeding, according to the health department. The boy had a “cluster of papules” on his penis and was sent to a dermatologist who then sent the boy to the emergency room.
The location of the lesions, timing of signs and symptoms, and laboratory identification of HSV-1 are consistent with transmission of the herpes virus during direct contact between the mouth of the ritual circumciser and the newly circumcised infant penis, the health department said.
Circumcision usually occurs on the eighth day of life, a time when an infant's immune system is not fully developed. While many adults can have mild cases of herpes, the virus can be far more dangerous if contracted by a newborn.
Dr. Thomas Farley, the city health commissioner under former mayor Michael Bloomberg, "strongly advised" the practice "never be performed."
In 2013, the Bloomberg administration instituted a rule that required mohels to obtain written consent before performing metzitzah b’peh. The consent form contained the warning that “the New York City Department of Health and Mental Hygiene advises parents that direct oral suction should not be performed.”
The policy, which did nothing to prohibit the practice, enraged many in the Orthodox community who felt their religious freedoms were being violated.
The regulation, according to reports in The Jewish Daily Forward, was rarely enforced, and in August a federal appeals court ruled it must pass a stricter constitutional test than was applied by the lower court.
During a Democratic mayoral primary debate in 2013, de Blasio was asked if he approved of the consent form, and he criticized Bloomberg for not engaging in a dialogue with the “community.”
“I would start over,” de Blasio said. “Change the policy to find a way to protect all the children but also respect religious tradition in an appropriate manner and come in Day 1 to City Hall with a new policy that's fair.”
De Blasio has not changed the policy.
When introducing Dr. Mary Bassett, his choice for health commissioner, de Blasio said he intended to leave the Bloomberg consent policy in place until some better policy could be found.
“I've said we will keep it in place while searching for a solution that is more effective,” de Blasio said at the time. "The current approach can be better and that's what we are going to figure out a way to do—with the community.”
De Blasio has not changed the approach.
His office did not immediately respond to a request for comment.