Penile herpes simplex virus type 1 infection (after Jewish ritual circumcision)

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Penile herpes simplex virus type 1 infection (after Jewish ritual circumcision) is caused by the practice of metzitzah b'peh by mohelim in which the newly circumcised penis of the infant boy is taken into the mouth of the attending mohel and sucked.[1]

Holt (1913) showed the practice to cause infection with tuberculosis more than one hundred years ago.[2]

Herpes simplex virus infection

More recently reports of infant boys being infected with herpes simplex virus have come from the United States and Israel.

United States

Cases of infection of baby boys with herpes simplex have been reported in New York. Rubin & Lanzkowsky (2000) reported two cases of cutaneous herpes simplex infection after ritual circumcision.[3] Gesundheit et al. (2004) reported eight cases of HSV infection following ritual circumcision with oral suction. One infant developed HSV encephalitis with neurologic sequelae (long-term brain damage manifested by seizures and infantile spasms). Four had recurrent episodes. Six were treated with intravenous intravenous acyclovir. Infants with recurrent HSV infection were treated with oral acyclovir. Four mohels tested positive for HSV.[4]

Thomas R. Frieden, M.D.[a 1], M.P.H.[a 2], then New York City Health Commissioner, in an open letter to the Jewish community reported that one death and brain damage in another had occurred and warned against the practice of metzitzah b'peh.[5]

Israel

Distel et al. (2003) reported a case of herpes simplex infection after ritual circumcision in Israel.[6] Koren et al. (2013) surveyed births in Israel over an eight year period. Twenty-two cases of neonatal herpes simplex virus (NHSV) infection were found. One boy died.[7] Tzvi-Behr et al. (2016) reported five cases of infants with genital herpes simplex virus type 1 (HSV-1) infection after Jewish ritual circumcision. All infants were treated with intravenous acyclovir for 14 to 21 days as recommended, and were discharged at good clinical condition. One infant still suffered from febrile seizures after one year.[8]

See also

Abbreviations

  1. REFweb Doctor of Medicine, Wikipedia. Retrieved 14 June 2021. In the United Kingdom, Ireland and some Commonwealth countries, the abbreviation MD is common.
  2. REFweb Master of Public Health or Master of Philosophy in Public Health, Wikipedia. Retrieved 14 June 2021.

References

  1. REFweb (2008). Jewish Practices & Rituals: Circumcision - Brit Milah, Jewish Virtual Library. Retrieved 13 February 2022.
    Quote: Traditionally, the mohel sucked blood from the circumcised penis.
  2. REFjournal Holt LE. Tuberculosis acquired through ritual circumcision. JAMA. 12 July 1913; 61(2): 99-102. DOI. Retrieved 12 February 2022.
  3. REFjournal Rubin LG, Lanzkowsky, P. Cutaneous neonatal herpes simplex infection associated with ritual circumcision. Pediatr Infect Dis J. March 2000; 19(3): 266-8. PMID. DOI. Retrieved 13 February 2022.
  4. REFjournal Gesundheit, Benjamin, Grisaru-Soen, Galia, Greenberg,, David. Neonatal genital herpes simplex virus type 1 infection after Jewish ritual circumcision: modern medicine and religious tradition. Pediatrics. August 2004; 114(2): e259-63. PMID. DOI. Retrieved 13 February 2022.
    Quote: The cultural process of replacing ancient customs by modern wound care has to be encouraged by a heightened awareness of this potentially life-threatening medical complication.
  5. REFdocument Frieden, Thomas: An open letter to the Jewish Community from the New York City Health Commissioner PDF, City of New York. (13 December 2005). Retrieved 9 January 2022.
  6. REFjournal Distel R, Hofer V, Boggen-Goren S, et al. Primary genital herpes simplex infection associated with Jewish ritual circumcision. Isr Med Assoc J. December 2003; 5(12): 893-4. PMID. Retrieved 13 February 2022.
  7. REFjournal Koren A, Tasher D, Stein M, et al. Neonatal herpes simplex virus infections in Israel. Pediatr Infect Dis J. February 2013; 32(2): 129-3. PMID. DOI. Retrieved 12 February 2022.
  8. REFjournal Tzvi-Behr S, Schlesinger Y, Bar-Meir M, Megged O. Neonatal Genital HSV-1 After Jewish Circumcision. Clin Pediatr (Phila). November 2016; 55(13): 1245-47. PMID. PMC. DOI. Retrieved 13 February 2022.
    Quote: Herpes simplex infection in newborns is a life-threatening infection with high rates of morbidity and mortality.