JERUSALEM: Metzitzah: Two boys contract herpes

The Jerusalem Post
June 3, 2016

Two recent cases [of] herpes in babies following Brit Milah

by Jeremy Sharon
The Schneider Children’s Medical Center for Israel in Petah Tikva has reported two recent cases in which baby boys have been infected with the herpes virus following their brit mila.

The infections are believed to be the result of ritual circumcisions in which the metzitza ba’peh procedure was used, whereby the mohel, or person performing the circumcision, uses his mouth to suction blood off the penis after the foreskin has been cut off.

This practice is mentioned in the Talmud and codifications of Jewish law, but is now uncommon outside of the haredi community because of the risk of infection, and suction is achieved instead by means of a sterile plastic tube.

According to Schneider, one baby was released last week after having been infected with herpes, while another baby was admitted to the hospital two months ago with the same disease.

“Both children were quickly examined, treated appropriately and released in excellent condition. Both of them will continue to receive oral treatment until the age of six months,” Schneider said.
The hospital reiterated its backing of suction via a tube instead of by mouth “to avoid this difficult infection.”

According to Rabbi Moshe Marciano, director of the circumcision division of the Chief Rabbinate, the infected babies did not have the same mohel.

In one case, the mohel was the father of the infected baby, and is not an authorized mohel, while the second family refused to give the details of the mohel who performed the circumcision.

The Health Ministry confirmed that only one mohel had been identified, but did not indicate that is was the father of the baby.

Marciano said metzitza ba’peh is an approved practice for mohels authorized by the Chief Rabbinate, but added that parents can request that it not be used and the mohel is obliged to conform.

He also said that rabbinate guidelines state if the mohel has any wound or infection in his mouth he must not do metzitza ba’peh.

Metziza ba’peh has caused controversy in recent years, most notably in New York where at least 17 cases of herpes have been reported since 2000, resulting in two deaths.

Earlier story

ISRAEL: Baby's Penis Reattached after Mohel Botches Circumcision

Israel Hayom
August 7, 2015

Baby's penis reattached in hospital after brit goes wrong

After circumcision is botched, family members keep severed tissue on ice until baby arrives at hospital • "We are optimistic about the baby's chances of recovery," surgeon says after operation • Unclear what led mohel to remove part of baby's urethra [glans].
by Danny Brenner and Israel Hayom Staff 

An 8-day-old boy from northern Israel was rushed to the Pediatric Emergency Unit at the Rambam Healthcare Campus this week after a botched circumcision in which the mohel severed part of the baby's urethra [glans]. The infant underwent penis reattachment surgery, which doctors later pronounced successful.

The medical team praised the family for placing the severed tissue on ice until they arrived at the hospital, increasing the chances for a successful operation.

The reattachment surgery was performed by senior pediatric urologist Benjamin Hardak.

"These kind of procedures are relatively rare," Hardak said. "The operation was a success and we are optimistic about the baby's chances of recovery, but it is still too soon to know what the ramifications will be for the baby. We are monitoring his condition closely."

Following the surgery the infant was admitted to the Intensive Care Unit at the Ruth Rappaport Children's Hospital, part of the Rambam Campus.

Mohels (ritual circumcisers) undergo special training before being allowed to perform the delicate medical procedure.

According to the Health Ministry's statistics, complications following circumcisions occur in less than 1% of cases, with the most common complication being excessive bleeding. Details of what went wrong in the brit in question were not immediately available.

NEW YORK: Metzitzah: Another baby has herpes

Capital (New York)
Deceber 23, 2014

City reports new case of herpes after metzitzah b'peh

by Dan Goldberg
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.

Earlier story

NEW YORK: Metzitzah: Another baby gets herpes

Vos Iz Neias
January 29, 2014

New York, NY - NYC Health Dept. Issues "Alert" To Medical Community After New Case Of Neonatal Herpes From MBP

by Glen Silver
New York, NY - The New York City Department of Health and Mental Hygiene has issued an “alert” to the city’s medical community following a January 2014 case of neonatal herpes following the Jewish circumcision ritual metzitzah b’peh, or MBP.

According to the document, the newborn was the product of a full term pregnancy and underwent the MBP ritual on his 8th day of life, after which a doctor conducting a routine check-up the following week noticed a rash on the child.

After a series of unsuccessful treatments, HSV-1 (herpes simplex virus, type 1) was suspected and specimens were collected and sent off to the New York State Wadsworth Center Laboratories.

The child was hospitalized for treatment after the diagnosis of HSV-1 was confirmed.

According to the release it is the 14th laboratory-confirmed case of MBP-related HSV-1 on record at the Health Dept. since 2000, two of which resulted in death—-while yet another two young boys suffered brain damage.

The issue of MBP has continued to be a hot-button topic for New Yorkers, more specifically New York’s Jewish community after former-Mayor Michael Bloomberg’s implementation of parental consent forms sparked outrage.

At a January 16 news conference, new Mayor Bill de Blasio doubled down on his campaign promise to work with Jewish community members and religious leaders to actively seek an alternative to the consent forms, but said that for the time being they will remain in place.

Earlier story

NEW YORK: Mtzitzah: Mayor will keep consent form for now

New York Daily News
January 17, 2014

Rewind: Regulating Mezitzah B'Peh In NYC

by Celeste Katz
Mayor de Blasio will continue many of his predecessor's public health initiatives -- including requiring parental consent forms for mezitzah b'peh, he and his new health commissioner, Dr. Mary Bassett, said Thursday.

["A Satmar faction announced during the mayoral election that de Blasio had promised to remove the requirement in exchange for their votes – a claim de Blasio later said was false, even though it was made in English on a public address system in front of hundreds of hasidim by a leader of that Satmar faction who was standing only five feet from de Blasio when he made it." - Shmarya Rosenberg • FailedMessiah.com]

Bassett said "there have been some 13 infant deaths in the past decade related to risks associated with exposure to a practitioner who transmits herpes" during the circumcision ritual, which is observed by some Orthodox Jews and involves a mohel removing blood from the baby boy's wound by mouth.

The city is not outlawing mezitzah b'peh, Bassett said, but "we have to ensure that people understand the purpose of these regulations [and] do a better job of listening to their concerns about them."

De Blasio emphasized, "I've said we'll keep it in place while searching for a solution that we think is more effective... There hasn't been the kind of dialogue necessary to get to common ground." While the city can communicate better with those who want to continue the religious observance, he said, "our job is to protect children."
[video]

Earlier story

PITTSBURGH: Rabbi denies botching circumcison

TribLive news
January 6, 2014

Squirrel Hill rabbi denies botching circumcision

by Adam Brandolph
A Squirrel Hill rabbi denies botching a ritual circumcision that a lawsuit says caused a “catastrophic and life-changing injury” to an 8-day-old boy.

Rabbi Mordechai Rosenberg, 54, admits in court documents filed Monday that the boy was injured on April 28, but said he's not to blame. The boy is identified only by his initials in the lawsuit his parents filed last month in Allegheny County Common Pleas Court.

“Rabbi Rosenberg performed the Bris Milah in a careful and competent fashion, with the care and skill normally exercised by Mohels under the same or similar circumstances” and “denies that he is liable to plaintiff,” the response to the lawsuit says.

A Bris Milah is a ritualistic Jewish circumcision. A mohel is the person who performs the rite.
Attorneys for both sides could not be reached.

The lawsuit does not specify the child's injuries. It says his parents rushed him to Children's Hospital for emergency reconstructive surgery and leech therapy. Leeches help a body accept reattached parts by promoting blood flow and tissue regeneration.

Earlier story

NEW YORK: Hypospadias - rabbi botches circumcision

Courthouse News Service
December 5, 2013

Mom Claims Rabbi Botched Circumcision

by Nick Divito
BROOKLYN (CN) - A rabbi botched the bris of an infant who had a birth defect involving his penis, and then failed to preserve the foreskin, the boy's mother claims in Kings County Superior Court.

Rabbi Eliyahu Shain performed the bris on Benjamin Altman in December 2009 at New York University Medical Center's Pediatric Associates of New York City.

But the boy's mother, Staci H. Altman, says the mohel failed to recognize that the boy had hypospadias, a medical condition where the urethra develops [no, emerges] on the underside of the penis.

[Hypospadias is an absolute contraindication for circumcision.]

Since then, the boy's permanent injuries have caused him to suffer "great physical pain and mental anguish and loss of enjoyment of life," according to the lawsuit.

The circumcision was allegedly performed "outside of a hospital or appropriate medical facility," ...

The boy's mother seeks unspecified actual and punitive damages for negligence.

...

TEL AVIV: Botched baby in critical condition

Times of Israel
May 30, 2013

Baby in critical condition after circumcision

by Stuart Winer

Barely breathing boy rushed to hospital following ritual

A baby boy slipped into unconsciousness during a circumcision ceremony and was taken to hospital in a critical condition on Thursday.

The eight-day-old infant underwent the brit milah ritual at the Pinhas Lavon synagogue in Holon when he stopped breathing and lost pulse.

The family made desperate calls to Magen David Adom for an ambulance and to the Hazalah first response organization.

Medic Yehuda Mizrahi was first to arrive on the scene.

“When I arrived, the baby was completely blue, not breathing and with no pulse,” he told Channel 2, and described how he began resuscitation techniques, including massages to try to restart the boy’s vital systems. Finally an ambulance arrived and the infant was rushed to Wolfson hospital.

Doctors began investigating what might have caused the incident, including excessive blood loss, a congenital disease, or infection. [Hmm, I wonder. How about that wound on his penis?]