Public Health

Infection Risk Prompts New York City To Regulate Ritual Circumcision

There's no ready euphemism for this, so be warned.

The New York City Board of Health voted unanimously today in favor of a new regulation that would require parents of young boys who undergo ritual circumcisions involving "direct oral suction" to sign a consent form first.

Earlier this year, the health department warned parents and mohelin, the Jewish ritual circumcisers, to "follow strict infection control practices whenever a male baby is circumcised."

The health department had previously investigated infections of circumcised newborns with the herpes virus that causes cold sores. While nothing too serious for most adults, infections with HSV infection in newborns can lead to "death or permanent disability," the health department said.

Over a little more than a decade, the department became aware of 11 cases of serious herpes infections in boys circumcised outside the hospital. Ten of the children were hospitalized. Two died.

Most herpes infections in newborns are transmitted from mother to child. But that common route wasn't suspected in these cases. Instead they were linked to ultra-Orthodox Jewish circumcisions involving a "practice known as metzitzah b'peh, in which the circumciser (mohel, plural: mohelim) places his mouth directly on the newly circumcised penis and sucks blood away from the circumcision wound," a report on the investigation said.

The health department obtained a cease-and-desist order against one mohel involved in those circumcisions. The findings from that investigation were published in the Morbidity and Mortality Weekly Report in June.

Although the new regulation requiring consent would not ban the practice, it still drew fire. One mohel told The New York Times he would rather be jailed than go along with the consent requirements.

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