NEW YORK: Metzitzah; hospitals to warn parents

WSJ/AP June 7, 2012 NYC warns parents of rare circumcision ritual NEW YORK — Several hospitals serving New York City's large population of ultra-orthodox Jews have agreed to distribute a pamphlet to new parents carrying a warning from the health department that a rare form of ritual circumcision is dangerous, has killed at least two babies since 2004 and should be avoided. The fliers address a procedure called "metzitzah b'peh" in Hebrew that was once a widely observed religious tradition but was abandoned by most Jews starting in the mid-19th century because of fears it could spread disease. During the ritual, the person performing the circumcision, called a mohel, cleans the wound by sucking blood from the cut and spitting it aside. Doctors say that puts the child at risk of becoming infected with herpes simplex type 1, a virus that most adults have and carry in their saliva. In adults, that type of herpes is usually harmless, causing occasional cold sores, but to newborns it can be deadly. New York City's Department of Health and Mental Hygiene said Wednesday that the ritual caused herpes in 11 children, 10 of whom required hospitalization, from 2000 to 2011. Two developed brain damage. Two others died, including one last summer, officials said. "There is no safe way to perform oral suction on any open wound in a newborn," Health Commissioner Thomas Farley said in a statement. "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." All city-owned hospitals have agreed to distribute the flier, plus eight more, including several located in city neighborhoods with large populations of ultra-Orthodox Jews. City health officials have warned against the procedure before, and it has been a topic of intense discussion in the Orthodox community for years, but the department said has been stepping up efforts since the latest death. In the past, some rabbis in the city, which has the largest Haredi, or ultra-Orthodox, population outside of Israel, have resisted attempts to end the ritual, saying that the warnings about the risks were overblown and there wasn't enough evidence that it was causing herpes. Most reform and modern orthodox mohels clean circumcision wounds with sterile gauze, a sponge, or use a glass tube to suction away blood. Earlier story