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'''Penile herpes simplex virus type 1 infection (after Jewish ritual circumcision)''' is caused by the practice of ''meẓiẓah [[metzitzah b'peh]]'' by ''mohelim[[mohel]]im'' in which the newly [[Circumcision|circumcised ]] [[penis ]] of the infant boy is taken into the mouth of the attending ''[[mohel]]'' and sucked.<ref>{{REFweb
|url=https://www.jewishvirtuallibrary.org/circumcision-brit-milah
|title=Jewish Practices & Rituals: Circumcision - Brit Milah
|last=
|first=
|accessdate=2022-02-13
|format=
|quote=Traditionally, the [[mohel ]] sucked blood from the circumcised [[penis]].
}}</ref>
[[L. Emmett Holt |Holt]] (1913) showed the practice to cause [[infection ]] with tuberculosis more than one hundred years ago.<ref name="holt1913">{{REFjournal
|last=Holt
|init=LE
==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 [[Jewish circumcision|ritual circumcision]].<ref name="rubin2000">{{REFjournal
|last=Rubin
|first=
|etal=no
|title=Cutaneous neonatal herpes simplex infection associated with ritual circumcision
|journal=Pediatr Infect Dis J
|location=
|accessdate=2022-02-13
}}</ref> 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. Infant Infants with recurrent HSV infection were treated with oral acyclovir. Four mohels tested positive for HSV.<ref name="gesundheit2004">{{REFjournal
|last=Gesundheit
|first=Benjamin
|etal=no
|title=Neonatal genital herpes simplex virus type 1 infection after Jewish ritual circumcision: modern medicine and religious tradition
|journal=Pediatrics
|location=
}}</ref>
[https://en.wikipedia.org/wiki/Tom_Frieden [Thomas R. Frieden]], M. D.{{MD}}, M. P. H.{{MPH}}, 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’pehb'peh]]''.<ref name="frieden2005">{{REFdocument
|title=An open letter to the Jewish Community from the New York City Health Commissioner
|url=https://web.archive.org/web/20061214110055/http://www.nyc.gov/html/doh/downloads/pdf/std/std-bris-commishletter.pdf
|accessdate=2022-01-09
}}</ref>
===Israel===
Distel et al. (2003) reported a case of herpes simplex infection after ritual circumcision in Israel.<ref name="distel2003">{{REFjournal
|last=Distel
|first=Rotem
|init=R
|author-link=
|last2=Hofer
|first2=Vered
|init2=V
|author2-link=
|last3=Boggen-Goren
|first3=Sarah
|init3=S
|author3-link=
|etal=yes
|title=Primary genital herpes simplex infection associated with Jewish ritual circumcision
|journal=Isr Med Assoc J
|location=
|DOI=
|accessdate=2022-02-13
}}</ref>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.<ref name="koren2013">{{REFjournal
|last=Koren
|first=Amir
|init=A
|author-link=
|last2=Tasher
|first2=Diana
|init2=D
|author2-link=
|last3=Stein
|first3=Michael
|init3=M
|author3-link=
|etal=yes
|title=Neonatal herpes simplex virus infections in Israel.
|journal=Pediatr Infect Dis J
|location=
|DOI=10.1097/INF.0b013e3182717f0b
|accessdate=2022-02-12
}}</ref> 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. <ref name="tzvi-behr2016">{{REFjournal
|last=Tzvi-Behr
|first=Shimrit
|init=S
|author-link=
|last2=Schlesinger
|first2=Yechiel
|init2=Y
|author2-link=
|last3=Bar-Meir
|first3=Masket
|init3=M
|author3-link=
|last4=Megged
|first4=orliOrli |init4=O
|author4-link=
|etal=no
|title=Neonatal Genital HSV-1 After Jewish Circumcision
|journal=Clin Pediatr (Phila)
|location=
* [[Metzitzah b'peh]]
{{ABBR}}
{{REF}}
[[Category:Circumcision complication]]