2 Mohels Banned After Infants Contract Herpes in Circumcision Rite

The Forward

New York City has banned two mohels from performing a controversial circumcision rite after they were suspected of infecting babies with herpes.

But the city’s health department will not reveal their names.

Five infants have contracted herpes since September 2012, when the health department passed a regulation requiring mohels to get written consent from parents before using their mouth to suction blood from a circumcision wound — a religious rite known as metzitzah b’peh, or MBP.

MBP can transmit a strain of herpes from the mouth of a mohel to the infant and is potentially fatal to newborns, whose immune systems are underdeveloped. Infants who contract the disease can also suffer brain damage. The MBP rite is common in the ultra-Orthodox community.

In the past, some parents whose babies contracted herpes have refused to identify their mohel to city health officials. Of the five cases since the autumn of 2012, the health department has been able to identify just two mohels.

Only one of those mohels obtained written consent before performing the circumcision.

“In all of the cases, we have asked whether there were forms and, in the two cases where we were able to identify the mohel, we have requested them from him,” a health department spokeswoman told the Forward on July 24. Of these two cases, one had a form, which he provided, the spokeswoman said. The other one did not. “The department issued orders banning both mohelim” from practicing MBP, she said.

The spokeswoman would not name the mohels, citing privacy concerns. She also did not respond to several emails asking how the ban would be enforced and how the public could know the mohels in question were banned if their names were not made public.

More liberal Orthodox Jewish leaders do not support the MBP practice and deplored the latest news about its consequences. “I would hope that any mohel who unfortunately has transmitted a disease via metzitzah b’peh would stop practicingmetzitzah b’peh because of the safety of our children,” said Rabbi Leonard Matanky, president of the Modern Orthodox Rabbinical Council of America.

But Matanky stopped short of calling for the health department to release the names of the banned mohels. The rabbinic leader said it would be presumptuous of him to comment, because he did not have enough information about the cases or the legal reasoning behind the city’s decision.

New York’s consent form regulation was created in the wake of the death of a 2-week-old boy following ritual circumcision with MBP in Brooklyn in 2011.

MBP is a holdover from centuries ago, when saliva was the best way to clot a wound.

Today, more liberal Orthodox groups advocate that mohels who want to continue the practice should use a sterile pipette to simulate direct oral suction. Alternatively, some mohels use gauze. But some ultra-Orthodox groups, such as the Satmar Hasidim, consider MBP by direct oral suction to be commanded by Torah.

Oral herpes is a common infection that manifests itself as a cold sore but often has no visible symptoms. It is passed to the infant via the mohel’s saliva.

Babies whose mothers already carry herpes are immune to the virus. But babies who are not immune are at a high risk of illness.

Mohels in New York City perform MBP on an estimated 3,600 ultra-Orthodox boys each year.

Ultra-Orthodox mohels also perform MBP on the children of secular or religiously liberal Jewish couples, and these couples are often ignorant of the practice and its risks.

Since 2000, according to the city health department, 16 babies in New York City have been infected with herpes following MBP. Two of those babies died, and another two suffered brain damage.

The consent form tells parents that the health department believes MBP “should not be performed because it exposes an infant to the risk of transmission of [herpes] infection, which may result in brain damage or death.”

Several ultra-Orthodox groups filed a lawsuit in United States District Court for the Southern District of New York in October 2012, asking for an injunction against the regulation.

The groups claim that medical evidence showing that MBP causes herpes infection in infants is weak. They say that the regulation violates their communities’ freedom of religion and freedom of speech.

Judge Naomi Reice Buchwald postponed implementation of the regulation while she considered the case.

In December of that year another infant was infected with herpes. Although the regulation was not in force, a lawyer for the city confirmed for the Forward that the December case was the only occasion in which a consent form had been collected.

Since then, four other infants have been infected. The two most recent cases were in July of this year.

Many ultra-Orthodox mohels refuse to comply with the regulation.

For 18 months the Forward has fought to learn the identity of the mohel involved in the December 2012 infection.

The Forward filed a request under New York State’s Freedom of Information Law, seeking the identity of the mohel. The city denied the request, and a state judge upheld it in December 2013.

Supreme Court Justice Timothy Dufficy said that revealing the mohel’s identity would seriously undermine the city’s regulations that encourage individuals to report neonatal infections.

Dufficy wrote, “Individuals would be dissuaded from complying with the reporting requirements if their anonymity was compromised.”

The Forward has appealed his decision.