WASHINGTON, Oct 7 (Reuters) - There is not enough evidence to say circumcision protects men from getting the AIDS virus during sex with other men, U.S. researchers said on Tuesday.
A review of 15 studies involving 53,567 gay and bisexual men in the United States, Britain, Canada, Australia, India, Taiwan, Peru and the Netherlands failed to show a clear benefit for those who were circumcised, researchers from the U.S. government's Centers for Disease Control and Prevention said.
Circumcised men were 14 percent less likely to be infected with the human immunodeficiency virus, or HIV, than those who were were uncircumcised, but the finding was not statistically significant, the CDC researchers said.
"You can't necessarily say with confidence that we're seeing a true effect there," said the CDC's Gregorio Millett, who led the study that appeared in the Journal of the American Medical Association.
"Overall, we're not finding a protective effect associated with circumcision for gay and bisexual men," Millett said in a telephone interview.
But whether circumcision might lower the risk of HIV infection in sex between men had remained unclear. Gay and bisexual men play a much larger role in AIDS in many countries outside of Africa, the epidemic's epicenter.
For example, the CDC last week said 48 percent of the 1.1 million Americans infected with HIV are men who have sex with men. More than three-quarters of U.S. men are circumcised.
"We really cannot recommend overall male circumcision as a strategy for men who have sex with men in the United States," Millett said.
The CDC's Dr. Peter Kilmarx, who was not involved in the research, said the agency is preparing formal recommendations on circumcision in the United States, with a draft due to be made public early next year.
Millett said there are signs circumcision might protect certain gay and bisexual men depending on sexual practices.
The virus can be transmitted through blood or semen.
Studies in Australia and Peru showed that men who engaged in insertive anal sex only and were not being penetrated by male sex partners got a significant protective effect from HIV infection from being circumcised, Millett said.
"Of course, if you're being penetrated by a partner during sex, you being circumcised is not going to protect you from HIV infection," Millett said.
Millett said two U.S. studies and one in Peru conducted before the introduction in 1996 of combination drug treatment for HIV infections, called highly active antiretroviral therapy, or HAART, showed that circumcised men were 53 percent less likely to be infected with HIV than uncircumcised men.
He said it is possible that since the advent of HAART, which helped turn HIV infection into a chronic disease rather than a death sentence for many people, some gay and bisexual men may have felt freer to engage in risky sexual practices.
Americans pride themselves on their commitment to freedom of religion, but how much religious freedom is too much religious freedom? At the moment, the thorniest dispute over the issue concerns a male-circumcision ritual practiced by some Hasidic Jews in New York. The ritual is called oral suction, or metzitzah b'peh. After removing the foreskin, the mohel, who conducts the circumcision, cleans the wound by sucking blood from it. According to city health officials, the ritual may have caused three infants circumcised by the same mohel in 2003 and 2004 to contract neonatal herpes (one of the infants subsequently died). New York's city Health Commissioner recently issued a warning about the dangers of oral suction, leading some Orthodox Jewish leaders to complain that Mayor Michael R. Bloomberg had reneged on promises to let religious authorities handle the issue. Meanwhile, secularists like the writer Christopher Hitchens have attacked the mayor for banning smoking in restaurants while failing to protect helpless children from diseases transmitted by "religious fanatics."
Among other things, the rabbis fear that restrictions on metzitzah b'peh might lead to bans on male circumcision itself. And these fears aren't entirely unfounded. In 1999, a British family court blocked a religious circumcision of a 5-year-old boy on the grounds that it wasn't in the best interest of the child. The rabbis fear that once courts feel emboldened to make their own judgments about whether circumcisions are medically beneficial or harmful, the United States could go the way of the British court.
There are, after all, individuals and advocacy groups in America who oppose male circumcision on principle and could use the courts to their advantage. In 1997, a North Dakota mother whose son had been circumcised over her objection with his father's consent argued in federal court that North Dakota's ban on female genital mutilation - which some Muslims believe is compelled by the Koran - was unconstitutional. Because the state protected girls but not boys from a harmful and medically unnecessary procedure, the mother argued, it failed to treat boys and girls equally. Either both forms of circumcision had to be banned or both had to be allowed. Although the suit was dismissed, it points toward an aggressively secularist system, as in France, where inflexible visions of equality are used to curtail traditional religious practices.
America, with its longstanding tradition of accommodating minority religious practices, has chosen an alternative model, more consistent with the demands of a multicultural democracy. The harms of female circumcision are more obvious than those posed by the oral suction procedure in male circumcision, which no state has yet regulated. (There are 2,000 to 4,000 of these circumcisions performed each year in New York City, and no more than seven recorded cases of herpes.) U.S. judges and politicians should defer to religious authorities in the cases where reasonable people can disagree about the health risks.
Ultimately, the American compromise depends on a delicate series of judgments about when, precisely, private religious expression imposes harms on unconsenting and innocent third parties. Courts have held that Jehovah's Witnesses may not deprive their children of blood transfusions. But should the city of Newark be able to prohibit all police officers - including practicing Muslims - from wearing beards in order to foster a uniform appearance on the job? In a 1999 ruling, Judge Samuel A. Alito Jr. sided with the Muslim officers. Since Newark allowed police officers not to shave for medical reasons (typically if they had a skin condition), Alito said that it was discriminatory not to make an exception for those whose religion required them to wear beards. Alito stressed, however, that states can refuse to accommodate religious minorities in the interest of promoting public health, as long as they treat religious and secular citizens equally.
This Solomonic ruling makes sense, as far as it goes, but it doesn't tell us how deferential Alito will be to religious practices in other cases. The most prominent American conservative scholar of religious liberty, Judge Michael McConnell, agrees that noncoercive religious expressions, like yarmulkes worn by Jewish soldiers, should be accommodated. But he emphasizes that public prayer in schools, which coerces nonbelievers to pray, should be banned. By contrast, Justice Antonin Scalia, who generally opposes religious accommodations, supports prayer in schools because he says that the state needn't be neutral between religion and secularism. Let's hope that Justice Alito, whatever his views on Orthodox circumcision rituals, doesn't go that far. The beards of Muslim police officers should indeed be protected, but not as a cautious first step toward the goal of creating an openly religious state.
December 14, 2005 -- In a highly unusual move, the city's health commissioner has issued an "open letter" to the Jewish community urging that it stop an ancient circumcision practice that has infected seven infants with herpes.
Most mohels, men trained to perform the circumcision, remove blood from the baby using a sterile gauze pad, sponge or rubber suction bulb.
But some Orthodox parents insist on a "suction by mouth" method, in which the mohel puts his mouth to the wound.
"There is no reasonable doubt that the practice of metzitzah b'peh [suction by mouth] has infected several infants in New York City with the herpes virus, including one child who died and another who has evidence of brain damage," said Health Commissioner Dr. Thomas Frieden.
When the controversy first arose, Frieden agreed to allow a Jewish-community court to settle the issue of whether the practice should be outlawed.
That court has yet to rule.
Frieden said in his letter that some medical professionals have called for a government ban.
"It is our opinion that educating the community through public health information and warnings is a more realistic approach," he said.
David SeifmanRenowned authorities, one at Bloomberg-named medical school, blast mayor’s administration over controversial circumcision practice.
Debra Nussbaum Cohen - Staff Writer
A renowned expert on sexually transmitted disease denounced as “outrageous” this week the Bloomberg administration’s failure to ban New York City mohels from suctioning blood with their mouths from a baby’s penis in the circumcision rite.
“[It] is a major public health hazard,” declared Dr. Jonathan Zenilman, a professor of epidemiology at the Bloomberg School of Public Health — the Johns Hopkins University education and research center named for New York’s philanthropist mayor, its biggest financial supporter.
Zenilman, who grew up in an Orthodox family in Woodmere, L.I., warned that allowing the practice known as metzitzah b’peh “is actually crazy” due to the potentially fatal danger of transmitting herpes to vulnerable newborns.
A prominent colleague, Dr. John Santelli, chair of the Department of Population and Family Health at Columbia University’s Mailman School of Public Health, joined the criticism.
“Those kids are at very high risk of death and encephalitis,” he said, explaining, “If you cut the skin — as obviously you have to in a circumcision — it increases risk of transmission to the infant. Newborns just don’t have great immune systems, so the worst time to get a case of herpes is in the newborn.”
Metzitzah b’peh, which is practiced routinely by some fervently Orthodox mohels, has been at the center of a case involving Rabbi Yitzchok Fischer, a Monsey-based mohel suspected of having infected three babies with herpes. One of the baby boys died last October.
But the city Department of Health and Mental Hygiene, which began investigating the suspected link of the infections to Rabbi Fischer, agreed not to ban the practice after vigorous lobbying by New York’s fervently Orthodox community, including of Bloomberg. In his re-election campaign, Bloomberg’s TV commercials tout him as a champion of public health.
On Sept. 15 the city withdrew the lawsuit it had filed against Rabbi Fischer and the court order banning him from using the technique, and turned the case over to an Orthodox rabbinical court, or bet din, in Williamsburg, Brooklyn. Rabbi Fischer agreed to stop using the technique pending the bet din’s resolution of the case.
This appears to be the first time the city has turned the adjudication of a public health issue over to a religious body.
Zenilman and Santelli said the narrow focus on Rabbi Fischer is misplaced. They said because Herpes Simplex Virus Type 1 is a very common disease — studies cited by the Health Department in its legal briefs say that 65 percent of Americans have contracted it by age 12 — the potential impact on public health goes far beyond concern over one mohel.
“From a public health standpoint, at the least there should have been a consent decree that this practice would not continue in this community,” said Zenilman, who also heads the Johns Hopkins Center for Reproductive Tract Infections and is president of the American STD (Sexually Transmitted Diseases) Association. “It is within the scope of a public health authority to ban it, and I find it outrageous that it hasn’t been.”
Santelli, who is also a pediatrician, stressed, “This is a public health problem. It’s certainly a dangerous practice from a medical point of view.”
Indeed, legal documents filed in connection with the case by the director of the Health Department’s Bureau of Sexually Transmitted Diseases, state that Herpes Type 1, which generally causes just fever blisters and cold sores in healthy older children and adults, is fatal as much as 30 percent of the time in newborns.
Dr. Susan Blank, the bureau’s director, turned down an interview request from The Jewish Week. Requests for access to the results of the Health Department’s investigation of Rabbi Fischer have gone unanswered.
Rabbi David Zwiebel, executive vice president of Agudath Israel, an umbrella body of ultra-traditional Orthodox groups, has said metzitzah b’peh is probably performed more than 2,000 times a year in New York City. Many additional instances occur in other areas with substantial populations of ultra-traditional Jews, such as Rockland County. Parts of the Orthodox community and Rabbi Fischer’s attorney frame the issue as one of religious practice that should be free from government interference. They question claims that it spreads herpes.
Mohels use antiseptic mouthwash before performing oral suction, they say, and the known incidence of herpes among infants who have undergone it is minuscule.
According to the Times, the city’s Health Department recorded cases in 1988 and 1998, though doctors in New York, as in most states, are not required to report neonatal herpes.
Prominent members of the large Satmar chasidic community, based in Brooklyn and Rockland County, including Rabbi David Niederman, a spokesman for the rabbinical court handling the case, have told The Jewish Week the community will continue the practice. A delegation of chasidic leaders lobbied Bloomberg on the issue in August. Their bloc vote is sought after by mayoral candidates.
“We’re going to do a study and make sure that everybody is safe, and at the same time it is not the government’s business to tell people how to practice their religion,” Bloomberg said on a radio program one day later.
Health Commissioner Thomas Frieden told the Times the city did not intend to ban or regulate the practice, partly because any such an attempt would be virtually unenforceable. Circumcision generally takes place in private homes.
Not all ultra-traditional groups mandate the practice, and the Modern Orthodox-oriented Rabbinical Council of America recommends using a sterile tube and gloves to avoid direct oral-genital contact.
The criticisms by Zenilman and Santelli come in the wake of a paper in the medical journal Pediatrics last year that studied eight cases of baby boys in Israel who developed herpes after their circumcision, “most probably as a consequence of transmission by the mohel’s saliva,” it stated.
“Oral metzitzah after ritual circumcision may be hazardous to the neonate” because it “carries a serious risk for transmission” of the herpes simplex virus, the paper concluded.
Asked its reaction to the experts’ warning this week, the Health Department reissued a statement it released last month:
“Our goal was for Rabbi Fischer to discontinue practicing metzitzah b’peh,” a spokesman said. “He has now agreed to do so. It has always been our preference for the religious community to regulate itself as long as the public’s health was protected.”
While cases of herpes transmission from mohel to baby are rare, they are documented going back as far as an 1811 medical book that detailed an outbreak in Krakow’s Jewish quarter.
Metzitzah b’peh was abandoned by all but fervently Orthodox mohels in the 1950s, when diseases including herpes, syphilis and gonorrhea were shown to be transmitted from mohel to baby.
As with Herpes Type 2 — the kind that results in genital blisters in adults — there is no cure for Type 1, only treatment for outbreaks. The virus can be passed from one person to another even when there are no symptoms, say medical experts.
“It’s often an asymptomatic disease,” Santelli said.
According to Zenilman, “People shed the virus occasionally even without the presence of lesions,” and any immune system suppression, including cancer and HIV-AIDS, can prompt shedding. Even taking inhaled steroids for asthma can prompt someone to unknowingly shed the Herpes 1 virus.
An actual outbreak of lesions can be prompted by trauma to the mouth, like having a dental cleaning, by having a fever for any reason, or being congested, or by exposure to the sun.
“It’s an everyday occurrence,” Zenilman said. “Although an individual can look absolutely healthy and have no illness, they can be shedding virus.”
Transmitting the virus, he said, requires genital-genital contact, oral-genital contact or other direct transmission across mucous membranes, like contact between a herpes blister on someone’s finger and someone else’s mouth.
Rabbi Fischer’s attorney, Mark Kurzmann, has said the infection of the three baby boys — including twins from Brooklyn — which became evident shortly after Rabbi Fischer circumcised them is “nothing more than a tragic coincidence.”
The twins were circumcised on Oct. 16, 2004, and admitted to Maimonides Medical Center eight days later with fever and lesions in the genital area, according to court documents. Two days after that, one of the twins died of liver failure as a result of Type 1 Herpes Simplex Virus.
At about that time, the Health Department became aware of another baby, on Staten Island, who developed signs of herpes infection a week and a half after Rabbi Fischer circumcised him using metzitzah b’peh. That baby was hospitalized for three weeks and recovered after antiviral treatment.
Kurzmann said he had no comment in response to the statements by Zenilman and Santelli.
In a September interview, Kurzmann said “it appears more likely than not that the babies contracted the herpes from someone prior to the bris, or a person other than Rabbi Fischer after the bris.”
That, said Zenilman, is nearly impossible because of when and where on the boys the herpes lesions appeared.
If it had passed from mother to baby during birth, he said, it would have required that the mothers in question had active herpes lesions in the birth canal. The newborns, in turn, would have had sores all over their bodies, not just in their genital areas.
Alternatively, Zenilman said, a mother-passed infection would have caused an encephalitis-like disease, and the baby also would have shown evidence of the disease in his first week of life, before the brit.
It is also highly unlikely another nurse in the hospital or caregiver caused the infection, he said, as that would have required the nurse to spit on the baby’s penis or have direct mouth-to-genital contact that could have infected all three babies. n
Circumcision may result in a false belief that safe-sex practices are no longer required, implying a worsening of the incidence of HIV infection.
Two separate papers were presented at a conference in Brazil, claiming that male and female circumcision has the potential to reduce HIV acquisition. Such claims may conversely have negative consequences in the struggle against HIV and AIDS. At the recent congress of the Treatment Action Campaign (TAC), the findings of a study conducted amongst male South African participants were presented, suggesting that the circumcised penis is more resistant to HIV infection. TAC has been reported to be considering advocating circumcision as a result. We are encouraging them to reconsider their new strategy.
This study could dangerously mislead people into believing that if they are circumcised, they would be protected against HIV. The natural response of a circumcised male to these reports is to assume that he is more resistant to HIV infection than is the intact male. The implication being that even more circumcised men may engage in unsafe sexual practices under the false impression that they won't contract HIV. Equally troublesome is the fact that this study offers no indication on whether or not the receptive partner of the circumcised male will become more or less vulnerable to HIV infection. The female receptive partner’s risk will likely increase without adequate protection. A second study, performed by Stallings amongst African females in Tanzania shows that HIV transmission is also reduced among circumcised FEMALES. This has gone unreported by the media. Such selective reporting suggests the need for analysis from a gender prejudice point-of-view and suggests that male and female circumcision should be dealt with as a unity.
The foreskin is not just a piece of skin, but rather a highly specialized erogenous and immunological structure, which cannot be cut off like hair or fingernails. We are therefore concerned about the frequent uncritical reference to particularly the male study in the media. The promotion of its uncorroborated findings, without adequate understanding of the behavioral consequences, is highly irresponsible. Feedback offered to our organization indicates that some individuals are now advocating "chop-shops," where parents will be able to bring their children for the non-consensual, non-therapeutic removal of their foreskins.
The "Lancet", the pre-eminent medical journal in the world, rejected the publication of the above French study. The broad quotation within the media is therefore, premature and irresponsible since the study has not been peer- reviewed as yet.
When extrapolating globally, the hypothesis of this study could be proven to be wrong. The United States has a very high rate of circumcision coupled with the highest HIV infection rate in the developed world. Scandinavia on the other hand has one of the lowest rates of circumcision in the world coupled with a comparatively low incidence of HIV infection. Global trends should be more accurate than one, demographically limited study. Neither does current research point to a significant difference in infection rates in South Africa amongst the non-circumcising tribes such as the Zulus, and the circumcising tribes such as the Xhosas.
Other studies have thus far failed to corroborate that circumcision could prevent HIV. The highly respected Cochrane review, which conducted a meta-analysis of circumcision and its relationship to HIV, "found insufficient evidence to support an interventional effect of male circumcision on HIV acquisition in heterosexual men."
The most important emphasis of HIV prevention should focus on education, the use of non-contaminated medical equipment, and behavioral changes such as condom use, and not foreskin amputation. The amputation of the male prepuce removes the only movable part of the penis, causing increased friction during sexual intercourse, leading to micro-tears of tissue, and subsequent increased vulnerability to possible infection. In South Africa, ‘dry sex’ practices, whereby lubrication mechanisms are purposely removed, make HIV infection even more likely to occur. It has also previously been demonstrated that circumcised men don’t like using condoms as they suffer from a progressively desensitized penis.
UNAIDS has cautioned against circumcision. "If circumcision were promoted as a way of preventing HIV infection, people might abandon other safe sexual practices, such as condom use. This risk is far from negligible - already rumors abound in some communities that circumcision acts as a "natural condom". A sex worker interviewed in the city of Kisumu in Kenya summed up this misconception, saying, "I can sleep with circumcised men without a condom because they don’t carry a lot of dirt on their penis." Circumcision does not eliminate HIV infection. In one study in South Africa, two out of five circumcised men were infected with HIV, compared with three out of five uncircumcised men. Relying on circumcision for protection is like playing Russian roulette with two bullets in a (five-shot) revolver rather than three."
National Organisation of Circumcision Information Resource Centres of South Africa implores all organizations associated with the fight against HIV/AIDS to take note of these developments. We should not lose foresight in the fight against HIV/AIDS by these irresponsible statements promoting circumcision of healthy body parts of boys and girls as a preventative strategy. All children have a right to bodily integrity, and such procedures violate that right. This right is enshrined in the United Nations Convention on the Rights of the Child, to which South Africa is a state signatory.
NOCIRC-SA - National Organisation of Circumcision Information Resource Centres South Africa
NORM-SA - National Organisation of Restoring Men - South Africa - Contact D.R Ferris - National Coordinator ETHICAL AND MEDICAL CONSIDERATIONS Contact - Dr. D. Sidler Pediatric Surgeon
ICGI - International Coalition for Genital Integrity - Contact D. Bollinger
A circumcision ritual practiced by some Orthodox Jews has alarmed city health officials, who say it may have led to three cases of herpes - one of them fatal - in infants. But after months of meetings with Orthodox leaders, city officials have been unable to persuade them to abandon the practice. (Go figure!)
The city's intervention has angered many Orthodox leaders, and the issue has left the city struggling to balance its mandate to protect public health with the constitutional guarantee of religious freedom.
"This is a very delicate area, so to speak," said Health Commissioner Thomas R. Frieden.
The practice is known as oral suction, or in Hebrew, metzitzah b'peh: after removing the foreskin of the penis, the practitioner, or mohel, sucks the blood from the wound to clean it. (If anyone else did that, we would call it sexual molestation and put them in jail.)
It became a health issue after a boy in Staten Island and twins in Brooklyn, circumcised by the same mohel in 2003 and 2004, contracted Type-1 herpes. Most adults carry the disease, which causes the common cold sore, but it can be life-threatening for infants. One of the twins died.
Since February, the mohel, Rabbi Yitzchok Fischer, 57, has been under court order not to perform the ritual in New York City while the health department is investigating whether he spread the infection to the infants.
Pressure from Orthodox leaders on the issue led Mayor Michael R. Bloomberg and health officials to meet with them on Aug. 11. The mayor's comments on his radio program the next day seemed meant to soothe all parties and not upset a group that can be a formidable voting bloc: "We're going to do a study, and make sure that everybody is safe and at the same time, it is not the government's business to tell people how to practice their religion." (But it is the government's business to protect babies from being mutilated. Freedom of religion does not give you the right to kill, maim or mutilate.)
The health department, after the meeting, reiterated that it did not intend to ban or regulate oral suction. But Dr. Frieden has said that the city is taking this approach partly because any broad rule would be virtually unenforceable. Circumcision generally takes place in private homes.
Dr. Frieden said the department regarded herpes transmission via oral suction as "somewhat inevitable to occur as long as this practice continues, if at a very low rate."
The use of suction to stop bleeding dates back centuries and is mentioned in the Talmud. The safety of direct oral contact has been questioned since the 19th century, and many Orthodox and nearly all non-Orthodox Jews have abandoned it. Dr. Frieden said he hoped the rabbis would voluntarily switch to suctioning the blood through a tube, an alternative endorsed by the Rabbinical Council of America, the largest group of Orthodox rabbis.
But the most traditionalist groups, including many Hasidic sects in New York, consider oral suction integral to God's covenant with the Jews requiring circumcision, and they have no intention of stopping.
"The Orthodox Jewish community will continue the practice that has been practiced for over 5,000 years," said Rabbi David Niederman of the United Jewish Organization in Williamsburg, Brooklyn, after the meeting with the mayor. "We do not change. And we will not change." (They are proud of the fact that they continue to remain backwards, primitive and hurt their children. People like that shouldn't be allowed to have children.)
David Zwiebel, executive vice president of Agudath Israel, an umbrella organization of Orthodox Jews, said that metzitzah b'peh is probably performed more than 2,000 times a year in New York City.
The potential risks of oral suction, however, are not confined to Orthodox communities. Dr. Frieden said in March that the health department had fielded several calls from panicked non-Orthodox parents who had hired Hasidic mohels unaware of what their services entailed.
Defenders of oral suction say there is no proof that it spreads herpes at all. They say that mohels use antiseptic mouthwash before performing oral suction, and that the known incidence of herpes among infants who have undergone it is minuscule. (The city's health department recorded cases in 1988 and 1998, though doctors in New York, as in most states, are not required to report neonatal herpes.)
Dr. Kenneth I. Glassberg, past president of the New York section of the American Urological Association and director of pediatric urology at Morgan Stanley Children's Hospital of New York-Presbyterian, said that while he found oral suction "personally displeasing," he did not recommend that rabbis stop using it.
"If I knew something caused a problem from a medical point of view," said Dr. Glassberg, whose private practice includes many Hasidic families, "I would recommend against it." (He knows it does cause a problem, he just doesn't have the guts to say it. He's afraid of being ostracized from his community.)
But Rabbi Moshe Tendler, a microbiologist and professor of Talmud and medical ethics at Yeshiva University, said that metzitzah b'peh violates Jewish law.
"The rule that's above all rules in the Torah is that you cannot expose or accept a risk to health unless there is true justification for it," said Dr. Tendler, co-author of a 2004 article in the journal Pediatrics that said direct contact posed a serious risk of infection. (Yea! Finally, someone with some common sense.)
"Now there have been several cases of herpes in the metro area," he said. "Whether it can be directly associated with this mohel nobody knows. All we're talking about now is presumptive evidence, and on that alone it would be improper according to Jewish law to do oral suction."
The inconsistent treatment of Rabbi Fischer himself indicates the confusion metzitzah b'peh has sown among health authorities, who typically regulate circumcisions by doctors but not religious practitioners.
In Rockland County, where Rabbi Fischer lives in the Hasidic community of Monsey, he has been barred from performing oral suction. But the state health department retracted a request it had made to Rabbi Fischer to stop the practice. And in New Jersey, where Rabbi Fischer has done some of his 12,000 circumcisions, the health authorities have been silent.
Rabbi Fischer's lawyer, Mark J. Kurzmann, said that absent conclusive proof that the rabbi had spread herpes, he should be allowed to continue the practice. Rabbi Fischer said through Mr. Kurzmann that the twin who died and the Staten Island boy both had herpes-like rashes before they were circumcised and were seen by a pediatrician who approved their circumcision. The health department declined to comment on its investigation.
Instead of politics, religion and votes, let's put the babies first. Remember them? They are the victims, the ones dying and getting mutilated.NEW YORK (AP) -- City health officials are investigating the death of a baby boy who was one of three infants to contract herpes after a rabbi circumcised them.
Ten days after Rabbi Yitzhok Fischer performed religious circumcisions on twins last October, one died of herpes and the other tested positive for the virus, according to complaint filed by the health department in Manhattan Supreme Court.
The complaint, reported in Wednesday's edition of the New York Daily News, also said health officials later found a third baby who had contracted herpes after being circumcised by Fischer in late 2003.
Under Jewish law, a mohel -- someone who performs circumcisions -- draws blood from the circumcision wound. Most mohels do it by hand, but Fischer uses a rare practice where he uses his mouth.
Fischer's lawyer, Mark Kurzmann, told the Daily News that Fischer was cooperating with the investigation, although it's unclear whether Fischer submitted to the city's request for a blood test.
"My client is known internationally as a caring, skilled, and conscientious mohel," Kurzmann said.
By ANDY NEWMAN