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Controversial circumcision ritual led to infant's death from herpes, says death certificate

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(CBS News) The New York District Attorney's office is reportedly investigating the death of a 2-week-old boy who underwent metzizah b'peh, a controversial Orthodox Jewish ritual that involves orally sucking the blood from the circumcised baby's penis. According to the unidentified boy's death certificate, he contracted herpes simplex virus type 1 from the ritual, and passed away at a Brooklyn hospital in September 2011, the New York Daily News reported.

"We are looking into the circumstances surrounding the death of this child," said Brooklyn DA spokesman Jerry Schmetterer told the Daily News.

It is important to note that the metzitzah b'peh, also known as mezizah or oral suction, is not a commonly practiced part of the Jewish circumcision ceremony. In the uncommon ritual, the mohel (or rabbi performing the circumcision) uses his mouth to draw blood away from the circumcision wound. While in the past this has helped limit complications from the procedure, the danger of passing diseases orally, such as herpes, has led many to use a sterilized glass tube as a barrier or a straw to clean the wound.

According to the New York City Department of Health and Mental Hygiene, most adults have oral herpes but don't show symptoms, and the disease is spread easily from saliva to a cut or wound. Because the immune system of newborns is not developed enough to fight serious infection, herpes infections pose grave risks to infants.

The department does not recommend infants undergo this ritual because there is no proven way to reduce herpes transmission risk. The department suggests parents speak to their mohel before a circumcision, since some parents might not know whether or not he'll perform the ritual.

This isn't the only documented case of a child contracting herpes during the ceremony. In 2005, twin boys died after contracting the virus from their mohel. According to the Israeli newspaper Haaretz, he was banned from performing the ritual.

Traditional Jewish circumcisions, known as a bris, can also raise a baby's risk for a urinary tract infection, studies suggest. A 2008 study showed that out of 162 babies under two months old hospitalized for urinary tract infections in Israel, 108 were boys, Haaretz reported. "We saw the same phenomenon in each hospital - a wave of urinary tract infections around the ninth day after pregnancy," Prof. Yaakov Amir, who conducted the study, said. There was no discernible time pattern for girls. It was also more common for babies who underwent circumcision by a mohel rather than a physician to suffer from an infection, which could also be due to poor bandaging practices, the study found.

Circumcisions are tied to health benefits, however.

Men who have been circumcised have a lower risk for infection with HIV, the virus that causes AIDS, according to the CDC, and the procedure seems to offer some protection against genital ulcer, Chlamydia, and penile cancer.

The NYC Health Department has more in "Before the Bris: How to Protect your Infant Against Herpes."

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