Another infant in New York City has been infected with herpes during a metzitzah b’peh ritual, city health authorities reported.

The infection occurred in November, according to an official statement. The baby was diagnosed with herpes 12 days after his circumcision, during which the mohel applied direct oral suction on the infant’s penis. The infection is the fourth reported herpes infection due to metzitzah b’peh in New York City in 2014, and the 17th since 2000.

The infant is not seriously ill and has since been released from the hospital, officials said. Two of the 17 infants infected since 2000 have died.

City regulations require that parents sign consent forms before a mohel performs the risky ritual. Yet the Forward has reported that the city is not enforcing that regulation, and that some rabbis are continuing to perform it. Ultra-Orthodox leaders have vigorously opposed the regulation, and their spokesman threatened civil disobedience before it was passed.

The city’s department of health said that it was working to determine whether the mohel who performed the circumcision had obtained a consent form from the parents for the metzitzah b’peh ritual.

Rabbi David Zwiebel, executive director of the ultra-Orthodox umbrella group Agudath Israel of America and an opponent of the health department’s effort to regulate metzitzah b’peh, cast doubt on the health department’s assertion that the herpes infection could be attributed to the ritual performed on the baby.

“I find the work attributable to be too strong of a word for situations where there’s no indication at all that the health department did any testing whatsoever, or investigated the possibility that one of the other caregivers may have been the transmitter of the virus,” Zwiebel said.

Zwiebel acknowledged that, in this case, the infant had herpes sores on his penis, but said: “That still doesn’t preclude that it might have been transmitted from a different source.”