The following is an unedited AP article:
With a swift swipe of his scalpel, Rabbi A. Romi Cohn circumcises the baby boy, then leans down and sucks the blood from the wound as prayers in Hebrew fill the Brooklyn synagogue.
The Orthodox Jewish tradition known as oral suction circumcision reaches back to biblical times but it has created a modern-day dilemma for New York City health officials, who have linked it to 17 cases of infant herpes since 2000. Two died and two others suffered brain damage.
Mayor Bill de Blasio’s administration, which came into power a year ago with a promise to reconsider an existing regulation on the ritual, is now negotiating with a group of rabbis over how to protect children’s health while still preserving religious freedom.
“The talks are ongoing but I cannot go into particulars,” said Avi Fink, the mayor’s deputy director of intergovernmental affairs who has been leading the talks. “Our goal is to achieve awareness of the risks.”
Such oral suction circumcisions are relatively rare, even in New York City, which is home to more than a million Jews — the largest Jewish population outside Israel. City health officials estimate more than 3,000 babies are circumcised each year using the oral suction method — formally called metzitzah b’peh in Hebrew.
A 2012 report by the federal Centers for Disease Control and Prevention advised against the practice, saying it increases the risk of herpes infection in baby boys by 3.4 times that of other male newborns.
Oral suction circumcisions first came under scrutiny during Mayor Michael Bloomberg’s administration, and the city’s health board voted in 2012 to regulate the practice by asking a parent or guardian to sign a consent form indicating possible risks.
Health officials point to a number of factors they say have linked the known cases to the ritual. They look for lesions on the genitalia, indicating that’s where the virus started. In addition, lab tests have showed that the timing of the infection coincides with the circumcision.
Two cases were recorded after oral suction in 2013 and four last year. In the most recent case, diagnosed in November, a baby boy was found to have lesions on his penis. But of those six cases, parents refused to identify the person who performed the circumcision — called a mohel — in four.
In the two cases in which the circumcisers were identified, both declined to be tested, the Health Department said. They were banned from performing the ritual.
The consent forms remain the regulatory standard for now, but most ultra-Orthodox rabbis have told their faithful not to comply, and the city acknowledges it does not collect them unless there is suspicion of herpes.
Cohn, an 85-year-old Holocaust survivor and native of what today is called Slovakia, is chairman of the American Board of Ritual Circumcision, which has certified 90 mohels, says he doubts the oral suction method had anything to do with spreading herpes. Cohn believes the infants may have been infected by the mother or another source.
“They’re wild accusations without any basis,” Cohn said. “I’ve done 35,000 circumcisions and never had an infection, of any kind.”
The rabbi does warn parents that circumcision, in general, has its risks, just like any medical procedure. His association mandates herpes testing and rinsing with mouthwash before the ceremony, in addition to scrubbing and sterilizing hands.
The rabbi followed those precautions one morning at Brooklyn’s Congregation Shaare Zion, where he circumcised week-old Yosef Sananas.
Cohn first administered a topical anesthetic, wrapping gauze around the child’s legs to isolate the sterilized area. Then the baby, on a white pillow, was carried into the main worship space.
Invited guests watched as Cohn did what he’s done thousands of other times.
“He’s the best mohel in New York,” says the boy’s mother, Becky Sananas. “We chose him because we trust him.”
While New York City wrestles with the issue, suburban Rockland County — itself home to thousands of Orthodox Jews — seems to have found a solution.
For any suspected case after circumcision, county health officials use DNA testing to try to link a baby with the source of infection. Since the county introduced the protocol in 2013, three infant boys were diagnosed with herpes; the DNA of two mohels did not match the boys’ and the third test was inconclusive.
Members of the Jewish community participate voluntarily in the process, working with Dr. Oscar Alleyne, Rockland’s director of epidemiology.
“That proves that they trust us,” Alleyne said. “We have cooperation, along with a scientific approach.”
(AP)
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30 Responses
Be wary of the source of this article. They have in the past shown a left wing political bias, and an ignorance if not open bias against frum Jews.
And why won’t New York do the same as Rockland and prove it conclusively?
2, Good point. They claim it’s an expensive test. I don’t believe this. Rockland county has a much smaller population and could afford this. Bloomberg on the other hand has verbally expressed his disdain for judaism (or orthodox judaism), and was obviously not interested in confirming via conclusive dna as opposed to inconclusive coincidence, rather than confronting religious freedom.
We’re missing the main point. All Miforshai Hashas and Noseh Keilim on Shilchon Oruch, including the Mishna Brura, clearly say that the only purpose of Mbp is for medical safety.
Even the Chadishei Haran writes “once the Prioh was done then the activity of Milah completed”.
We erroneously keep on talking about MBP as if it is part of the Mitzvah.
Thank you Ader! Someone who knows how to learn!
@ader “v’al titosh Toras imecha.”
“he doubts the oral suction method had anything to do with spreading herpes.”
And where did he get his epidemiology training?
“Cohn believes the infants may have been infected by the mother or another source.”
He just accused the mothers of licentious behavior. Shame on him.
4
If you allow the govt to get involved AT ALL in milah, YOU CAN KISS IT GOODBYE!!! There are so many haters, self haters and otherwise, who are trying to do whatever they can to stop bris milah. To think differently, means your head is in the sand.
WE CANNOT ALLOW THE SONAY YISROEL, THE GOVT, SELF HATING JEWS, LIBERALS &FEEL GOOD DEMOCRATS, TO TELL US HOW WE COULD OR SHOULD OBSERVE OUR MITZVOS AND MINHAGIM!!!!
Ader: isn’t THIS the point. “If we have a mesotah that MBP is safer medically, then by all means, it is!!!
Besides, this article is grossly biased. It puts down very controversial statements as facts, while they were proven totally false. NEVER ONCE was it even partially proven that there is any connection btwn herpes and MBP. these are all assumptions by those who clearly have no interest in the real truth. Cuz if they would, DNA testing would’ve long been the regular protocol here and then we’d all conclusively know the answer! I’ve been one of the harassed for MBP. They have as much proof that MBP causes herpes, as Obama does on Iran’s safe usage of nuclear plants!
Go do your homework and you’ll agree w me!
Sorry ader,YOU are missing the point and erroneously posted here! Metziza Bpe IS PART of the mitzvah and you were not hired to decide the reason for that. We follow a mesora and don’t change it based on the “reason.” The only reason this is even a story is because a “knowledgeable” Jew decided to question our mesora. “Knowing” how to learn means nothing if you don’t know how to follow it’s Mitzvos! Sad!!
Marc, wow! Your finally on the ball!
Keep those haters out of our lives.
Charlie,
“And where did he get his epidemiology training?”
You don’t have such training either.
What he does have that you don’t is 65 years of experience and 35,000 bris sim and plain common sense.
“he just accused the mothers of licentious behavior”.
No he did not. Were you possesed of even a smidgen of common sense you would know that mothers change babies diapers and clean those areas.
What you did prove is that your mind is in the gutter.
Your wife, the doctor would be and should be highly embarrassed of your inane comments. Though I suspect that that ship has long sailed. This is far from the first time you have made such inane remarks.
In the midbar it was a sakana to do the milah never the less shevet levy didn’t stop from preforming it. They were rewarded.
Mbp is in the hands of the Rabonim. Not on the opinion of some bloggers.
Ader,
My family tradition also generally is that MBP isn’t obligatory.
Is it at all relevant?!
Allowing governmental bodies or pseudo governmental bodies
to infringe on relgious tradition of any segment of the general community
(supported and/or instigated invariably by the same crowd giving themselves a platina of sudden piety)
is the sure beginning of a dangerous slippery slope.
“First they came for…
Then they came for…
then they came for…”
To # 6 & 9
There is no such a thing as ‘V’al Titosh Toras Imecho’, or Mesorah, regarding something that our parents did for Medical purposes.
It’s like somebody who follows his mother’s old medical remedies because of V’al Titosh.
surigol- I don’t know all of the scientific facts on the ground, but I find it hard to believe that the “left” and all the medical experts have any motivation other than safety. I don’t think there is any anti-Semitic bias (though there might be a bias because they think the practice is weird and disgusting).
But in terms of mbp and health w/regard to Mesorah, I would like to make two points:
1) If I’m not mistaken, the Gemara also says that bathing the baby in warm water is crucial for the baby’s health, which is something that we no longer do. It seems that the health suggestions in that Gemara don’t necessarily have a source in Mesorah.
2) The Gemara only speaks about oral suctioning but not that there has to be direct contact between the mohel and the baby. I don’t know where that minhag first developed, but it seems from the Gemara that using a tube would provide the health benefits of oral suctioning without the modern day health concerns.
nishtdayngesheft,
Obviously it you that lacks even a smidgen of common sense. The mother would need to have the HSV in her in order to transmit it to her baby. She would not have picked it up at the market. The only way to have the disease yourself would be through transmission of bodily fluids, hence the accusation of licentious behavior is quite apt.
Also, Dr. Hall is a professor in the Department of Epidemiology & Population Health at Albert Einstein College of Medicine.
What someone’s mother does is irrelevant when we’re talking about the Torah… mesora is mesora whether you agree or think you know the reason or not. We do not question the reason for God-given Mitzvos. Hashem didn’t say follow until you no longer think it’s applicable. Mbp is part of our mesorah and part of the bris whether or not you agree, in its original form. The fact that someone can convince people who consider themselves frum not to listen to halacha is impressive…
There are medical questions, halachic questions, and legal questions. We need the experts in each field to step forward and espouse opinions on their expertise.
Here are my nonexpert opinions:
1. Anyone who says mbp medically CAN’T cause herpes in an infant is an idiot
2. The government shouldn’t be regulating religious behavior without an unassailable basis as to danger in fact. They could a lot more here.
3. IDK enough halacha regarding milah, mbp, and safek pikuach nefesh to have even an uninformed opinion. I doubt many others here know more than me.
Bottom line: Nothing is simple but a common denominator between everyone is a desire for more frum yidden to be in the world. Really not the end of the world, right?
#15 #16,
read #14
“I don’t know all of the scientific facts on the ground, but I find it hard to believe that the “left” and all the medical experts have any motivation other than safety ”
Well then.Get a reality check
Probably the “left”‘s promotion of abortion of full term babies-and many even privately promote the right to murder newborn for several hours post -birth – is also all out of the same concern for infant safety
About uncovered water and wine, and mayim achronim, among many others, the Vilna Gaon paskined that we cannot stop fulfilling these precepts (for lack of a better word) simply because the reason brought in the Gemorah or CHaZa”L no longer applies. He explains CHaZa”L only give one (or perhaps several) reasons, but there are always many more they did not reveal. Therefore we must continue being careful with these things. The same should apply here.
Shuali- there’s a difference between a “precept” of Chazal no longer applying, and a discovery that a “precept” of Chazal may cause dangers that Chazal didn’t know about it. We are usually machmir about even safek pikuach nefesh, it seems strange that many want to be so meikil here.
And like I said, Chazal talks about oral suctioning, but not that there needs to be direct mouth to baby contact. Using a tube would fulfill the “precept” of Chazal, without the potential and possible dangers.
@simcha613 I find it fascinating that you think you know better than Chazal about MBP. As for your safek pikuach nefesh, it seems that the mohel identified in the article takes sufficient precautions to prevent any possible infections. If only all those performing procedures in our hospitals were so diligent, many more lives would be saved.
Simcha613:
Yes. MBP is a very queer sounding custom and there’s ample reason for any non Jew or self hating Jew to try to mock it, etc. As for the medical world: I’ve had my share in proving to myself beyond any doubt, that they have an agenda! If you truly wanna know the truth, whether you do MBP or not, talk to ANYBODY THAT WAS INVOLVED. Before you do that, you’re biased. Your custom should NOT be the deciding factor. The ‘medical experts’ never agreed to do any testing that can prove definitively who is truly at fault, even though the affected ones were ready for it. This is a FACT! WHY oh WHY???? Now that Rockland County is finally doing this, due to their honesty, the truth is coming in thick and fast…..
To frumnotyeshivish:
”Here are my nonexpert opinions:
1. Anyone who says mbp medically CAN’T cause herpes in an infant is an idiot”
NONEXPERT OPINION INDEEED! and you obviously haven’t even done the minimum research to post here!
According to studies proven in medical books, you indeed have no knowledge regarding this matter, and thus have no right to post.
As I said ‘do your unbiased research, and you’re bound to agree with me!’
EVERYBODY PLEASE NOTE: contempt before research is active stupidity!!
simcha613 et al ,
You’re once again trying to run from the sunlight into the fog ?
simcha613,
If you wish to debate this ad infinitum (or any other aspect from Chazal) in a vacuum,be my guest.
But the nefarious united forces on the offensive (even those wearing headcoverings) against MBP are “an everpresent danger”
we can ill afford to give an inch
Chazal never say that Metzitza Bfeh is a part of the mitzva.
This discussion is not about wether we as a community should continue the practice of MBP. The question is, is there a risk, and if so what we are doing to mitigate it, and is the risk of a proportion as such that it warrants government intervention.
From a risk perspective, there is no proof of any confirmed cases caused by MBP. The proof is the Rockland cases, that while they seemed obviously related, the DNA proved otherwise. NYC had claimed 7 cases. What they have refused to disclose is how many non circumcised infants contract herpes. They have not proven that there is a greater statistic with circumcised orthodox children.
Even if we were to assume all 7 cases were related to the MBP, although NYC already confirmed that in two of them there were siblings affected prior to the bris, then statistically is that of any higher outbreak of any other medical procedure. It is estimated that the MBP is performed about 4500 times a year in nyc, and the 7 cases is over a five year period. That’s 7/18000 or .04%. That’s lower than the risk of infection in any procedure in any hospital in NYC. Does that warrant government intervention? Why don’t they require consenting adults to acknowledge the risks of std’s every time they copulate? 25% of NYC women reportedly have an STD. The answer is clear that this is an intervention in a religious practice they find offensive.
As for wether we should out should not continue that practice, each parent has the right to choose how to live his religion. Even if it no longer serves a purpose, I should have that right.
let me be clear, I am not arguing on chazal. If anything, I am arguing against the doctors and health experts of their day.
If there was a Mesorah from Har Sinai that metzitzah is for the baby’s safety, then obviously Godly knowledge is more accurate than modern science.
But if chazal gave a safety precaution based on their contemporary medical knowledge, then I would trust modern medicine more than theirs. Do you still engage in blood letting?
I don’t know if the source of metzitzah is Mesorah or contemporary science, but it seems like it’s not Mesorah, as many of the other health practices in that sugya are no longer practised. If that’s the case, then you’re not defending chazal but you’re defending their Babylonian doctors.
But all that is irrelevant because Chazal only spoke of metzitzah, not metzitzah bapeh (look it up if you don’t believe me), so the “requirement” for direct oral suction is actually a later enactment. Using a tube for metzitzah is not violating any enactment of Chazal and you avoid the possible (and I admit it’s only possible) dangers of direct metzitzah bapeh.
Surigol: IDK if you are reading this. I have done research. I have seen studies. Clearly, I understand them better than you. The question is not whether HSV can be transmitted from an infected person via an open cut, the question is which preventative measures are sufficient and appropriate. I’m not saying any chiddush here. If you have evidence otherwise please cite the source. Thank you.