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A seldom-practiced religious ritual has led to a cluster of herpes cases among infants, New York City health officials said Sunday. At least four infants have contracted the potentially fatal viral disease since last September, all after undergoing a circumcision during which the circumciser placed their mouth on the genital wound.


Last September, health officials issued a public health alert about the practice, known as metzitzah b’peh, following a case of neonatal herpes reported to the New York City Health Department. On Sunday, the Wall Street Journal reported there have been three more cases documented in NYC since December.

Jewish circumcision nowadays rarely involves any oral contact between the baby’s genitals and the circumciser, or mohel, and is actively discouraged by the community at large. But the ancient practice of suction—said to cleanse the wound—is still performed within some ultra-orthodox communities.


There are two species of virus that can cause herpes: herpes simplex 1 (HSV-1) and herpes simplex 2 (HSV-2). HSV-1 typically causes oral herpes and is much more common, affecting over half the U.S. population, while HSV-2 typically causes genital herpes (that said, both viruses can also sometimes cause the other type of infection). Most people with HSV-1 never experience any symptoms, and acute cases are usually mild and self-limiting. But in infants, an infection can be life-threatening and require urgent care.

According to the Wall Street Journal, the infants were all hospitalized and received two weeks of intense antiviral therapy but are now recovering. There have been several deaths and cases of irreparable brain damage linked to circumcision-related herpes in the city since 2000, however.

Since April 2006, there have been 19 other documented herpes cases related to circumcision, excluding the current wave of cases, according to the health department’s recent public alert.

Many Jewish parents may not even know about the health risks of the ritual or that there are other religiously sanctioned alternatives that are perfectly safe, health officials have said in the past. And even if they decide to go ahead with the ritual, there are still ways to reduce the risk of transmission, such as the mohel using alcohol-containing mouthwash immediately before the ceremony. The city has also mandated that mohels previously identified to have spread herpes not conduct these types of circumcisions any longer.