US health officials are warning that a Jewish ritual called "oral-genital suction," performed during some Orthodox circumcision ceremonies, can significantly increase the risk of infants contracting herpes virus infections.
The New York City Health Commissioner Dr. Thomas Farley issued a public advisory cautioning against the ritual, after 11 infants were reportedly infected with the virus since 2000, two cases resulting in death and another two cases leading to brain damage.
Oral-genital suction, known as metzitzah b'peh, can put infants at risk of infection because the adult performing the circumcision places his mouth on the circumcision wound to suck blood away from the cut. The ritual is conducted by very few sects within the Orthodox Jewish community.
"There is no safe way to perform oral suction on any open wound in a newborn," 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," he added.
Farley added that several hospitals, including those serving the haredi Orthodox Jewish community, have agreed to distribute a brochure that describes the risk of contracting the herpes virus from the practice.
According to a report published by the US Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, as high as 80% of adults carry the herpes simplex virus type 1, which is usually spread orally through common activities and is different from the sexually transmitted type 2 version of the virus.
The report states that the Jewish circumcision ritual more than triples the risk of infection among newborns.
"The infections we're talking about are not the ones people normally associate with sexual type interaction," said New York's deputy health commissioner, Dr. Jay Varma.
"Many actually acquire herpes type 1 when they are children, because it can be gotten through very casual contact. This causes what people commonly call cold sores in the mouth," he noted, adding that "we're not implying in any way that these mohel have done anything untoward in a sexual context. The point is that regardless if you're a mohel or someone else, having direct contact with the mouth and an open wound is a hazard."