Friday, February 10, 2006
From this week's CDC Public Health Law News:
"Rare circumcision rite causes stir in N.Y."
Associated Press (02/02/06) David B. Caruso
In response to the death of an infant from herpes last year, the New York state Health Department is drawing up safety guidelines governing a controversial circumcision practice. The practice, performed by some Hasidic Jews, involves cleansing the wound by sucking blood from the cut. Doctors have long warned that the procedure could spread disease, including the herpes simplex type 1, which causes cold sores in adults but can be fatal to babies. Hasidic leaders have been reluctant to stop the practice because they say it is commanded by Jewish law. The Health Department is preparing voluntary guidelines to help reduce the chances of infection. According to Department spokesman Robert Kenny, rabbis will probably be asked to talk to their congregations about the risks of the procedure, and parents will be instructed to seek medical care for infants who develop a fever or rash. Mohels (pronounced MOY-il), traditional ordained practitioners of the procedure, could also be asked to police themselves by being aware of their health status before performing the ritual. Some doctors have argued that the potential for harm is substantial enough to justify an outright ban of the procedure. "This is something that is pretty much counter to all of the infection-control measures that we have," said Dr. Jonathan M. Zenilman. But Rabbi David Niederman argues that there is not enough information to justify the guidelines. "We are not fanatics," he said, "If there is evidence that this practice is not safe, we will not do it. We will be the first ones to act."
CBS News' report of the possible connection between the 2005 death and circumcision is here. WebMD reported in 2004 on a study by Israeli researchers of the risks. The report cited 8 cases of infection, one of which resulted in brain damage to the newborn. According to the report: "Researchers say that after the initial cases of herpes in circumcised infants were reported, the Chief Rabbinate of Israel pronounced in 2002 the legitimacy of using instrumental suction in cases in which there is a risk of infection. 'We support ritual circumcision but without oral metzitzah, which might endanger the newborns and is not part of the religious procedure,' write researcher Benjamin Gesundheit, MD, of Ben Gurion University in Israel, and colleagues."