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Brooklyn, NY – On September 28, a 2-week-old boy died at Maimonides Hospital in Brooklyn. A subsequent investigation by the medical examiner office led to a determination of the official cause of death to be, “disseminated herpes simplex virus Type 1, complicating ritual circumcision with oral suction.”

This is basically a fancy way of saying that the newborn died after a rabbi with herpes cleaned the baby’s freshly circumcised penis with his mouth. Despite this sounding like a really good idea… it turns out that it is not.

Far from being some new fad, the ritual of oral suction — or in Hebrew, metzitzah b’peh — was first described some 1800 years ago in a section of the Talmud. The procedure is spelled out very clearly – as is the consequence of not doing it correctly.

If a surgeon does not suck, it is dangerous and he is dismissed.

Taken literally, the procedure occurs during the circumcision ritual as the practitioner, or mohel, removes the foreskin of the penis. He then sucks the blood from the wound to clean it.

The problem with this is that, according to the New York City Department of Health and Mental Hygiene, most adults have oral herpes but don’t show symptoms. The disease is also spread easily from saliva, to a cut or wound. Because the immune system of newborns is not developed enough to fight serious infection, a herpes infections poses great risk.

As the straw and sponge were invented centuries ago, as well, there has long been debate within the Jewish community as to whether the declaration in the Talmud necessitated using ones mouth directly on the penis of the baby. Records of this controversy can be found in the 1800s with less ‘intimate’ approaches being proposed.

Over time, the use of mouth suction eventually fell out of favor with all but the more strict Jewish communities – thus causing the practice have the unique distinction of being simultaneously unorthodoxed and ultra-orthodoxed.

In the case of the newborn who died in September, the mohel – who has not yet been identified by investigators – is believed to have been a member of the baby’s family. According to investigators, the family has, so far, been ‘uncooperative.’

This is not the first time that metzitzah b’peh has been linked to herpes infection or death. In 2003 and 2004, the city reported three cases of Type 1 herpes that were linked to circumcision, including a set of twins. One of the twins died as a result of the infection,  but – because of the lack of cooperation with in the Jewish community at the time – no charges were ever filed.

The best that New York City could do was to prohibit Rabbi Yitzchok Fischer, the mohel who performed the procedures, from performing the ritual in the city limits. A 2004 article in the journal Pediatrics also linked 8 cases of herpes infection with metzitzah b’peh. Despite all of this, the orthodox Jewish community resists any pressure to limit the practice.

“We’re not oblivious to what’s going on,” Rabbi David Zwiebel, the executive vice president of Agudath Israel of America, said while explaining that the mohels in the Hasidic community were cognizant of hygiene.  He added that  there were ‘things they could do’ to reduce the risk of herpes without ending the practice.

“The worst thing that could happen is if the authorities regulate this practice, then it could go underground,” Zwiebel cautioned. “I think the practice would continue, but there could be significant difficulty in gathering evidence.”

So, basically, if the city does nothing the practice will continue and if the city does something the practice will continue. Add to this, a 2-week-old baby is dead and the city is in a standoff with the baby’s parents and the orthodox Jewish community who appear to be hiding the c*@ksu@%er who caused the baby’s death.

Oy vey.

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