In an ultra-Orthodox Jewish practice known as metzitzah b'peh, the mohel performing circumcision on an 8-day-old male places the child's penis in his mouth for a moment to suck out the blood from the wound. As a result of this practice, 13 babies in New York City have been reported diagnosed with herpes simplex virus type 1 (HSV-1) since 2000. Two have died. The continuation of this dangerous practice is an example of an extreme religious group's prioritization of traditional practices over the welfare of its youngest members.
In adults, HSV-1 (different from the sexually transmitted HSV-2) causes the common cold sore, and is a fairly benign condition. For infants, however, HSV-1 can pose great risks. The New York City Health Department has issued a warning to parents considering a ritual Jewish circumcision for their child's bris, stating that "There is no safe way to perform oral suction on any open wound in a newborn."
Those in New York's ultra-Orthodox Jewish community tend to marry young and stay with the same partner for life. However, the health department warns that they are not safe from herpes: "A married couple who have only had sex with each other could still contract herpes simplex virus type 1 without sexual contact with anyone else." The Health Department has also been distributing pamphlets titled "Before the Bris: How to Protect Your Baby From Infection" to parents who intend to have an out-of-hospital circumcision performed on their newborns.
The great irony in this sad situation is that the intention of metzitzah b'peh was originally to protect the newborn boy from infection. By the 18th century, the risks of infection were already known, and many parents and mohels opted to use a sterile glass tube to remove blood from the wound. Still, many members of the ultra-Orthodox community, a rapidly growing segment of New York's Jewish population, prefer the method they consider more traditional despite the risks. Rabbis who defend the practice have argued that there is not enough evidence to show that metzitzah b'peh increases an infant's chance of contracting herpes.
The risks are clear: a study conducted between 1999 and 2004 showed that HSV-1 was present in 57.7% of American adults. According to the CDC, metzitzah b'peh is performed on 3,600 newborn boys a year, and the risk of contracting herpes among those babies is triple the norm. The overwhelming opinion of the medical community is that the practice is unsafe.
Those in the ultra-Orthodox community who defend metzitzah b'peh have found a supporter in infectious disease specialist Dr. Daniel S. Berman, who argues that there is no proven connection between oral suction and herpes, and that an attempt to curtail the practice is an example of religious bias.
What it boils down to is not a matter of safety, but a matter of how the religious text that calls for use of metzitzah b'peh is interpreted. Gary A. Gelbfish, a surgeon and certified mohel, says that it is unclear whether the Talmud dictates that metzitzah b'peh be performed, or whether it is simply a medical recommendation from a time of lesser awareness of infectious diseases. Gelbfish calls for a committee to review the Talmud as well as recent medical findings and decide whether to continue performing metzitzah b'peh. This seems like the most logical compromise, but for a community that rigidly conforms to religious mandates, any recommendation to alter traditional practices can seem like an attack on religious freedom.