Subject: NYC DOHMH Alert #4: New Case of Neonatal Herpes Infection Reported Following Ritual Jewish Circumcision
First Case Reported in New York City in 2017
Disease, Dermatology, Obstetric, Infection Control, and Microbiology Laboratory Staff
• When evaluating male infants with suggestive symptoms in the weeks following out-of-hospital circumcision, providers should inquire whether direct orogenital suction (metzitzah b’peh) was performed during circumcision and consider infection with herpes simplex virus (HSV) or other oral pathogens.
• Infants suspected of having HSV infection should be hospitalized and treated with intravenous acyclovir.
• Please distribute the Health Department’s pamphlet “Make a Safe Bris for Your Baby” to expectant parents and/or new parents who visit your office or facility. This is also available in poster format.
Diagnosis, Reporting, and Specimen Collection
For detailed guidance regarding diagnosis, reporting, specimen collection, and specimen shipping and handling, please refer to Health Alert #2 (January 28, 2014) at:
https://a816-health29ssl.nyc.gov/sites/NYCHAN/Lists/AlertUpdateAdvisoryDocuments/2014%20-%20NeonatalHSV.pdf
1. When evaluating male infants with suggestive symptoms in the weeks following out-of-hospital circumcision, providers should inquire whether direct orogenital suction (metzitzah b’peh) was performed and consider infection with HSV or other oral pathogens.
2. Herpes-infected neonates may not present with the classic finding of grouped vesicular skin lesions and may be afebrile.
3. Babies suspected of having HSV infection should be immediately admitted to the hospital and treated presumptively with intravenous acyclovir.
4. Distribute the Health Department’s pamphlet “Make a Safe Bris for Your Baby,” to expectant parents and/or new parents who visit your office or facility.
4. Health care providers diagnosing herpes infection in infants <60 days of age days are mandated to report the infection to the NYC Health Department within 24 hours of diagnosis.
5. Providers evaluating infants <60 days of age with suspected HSV infection are required by law to collect specimens from one or more vesicles (if present) or from any skin lesions suggestive ofherpetic disease, and to send these swab(s) to the New York State Wadsworth Center Laboratories for diagnostic testing using molecular methods.
Director of Surveillance
Bureau of Sexually Transmitted Disease Control
Assistant Commissioner
Bureau of Sexually Transmitted Disease Control
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The very idea of a mohel, who for lack of a better characterization is effectively a lay surgeon, infecting a fresh surgical wound on a neonate by direct oral contact runs counter to any and all concepts of hygiene and child protection. It’s child abuse and should not be allowed to be shielded by religious belief any more than should torture or starvation of children. As far as I’m concerned the parents should be criminally charged when a child turns up with herpes and legally forced to divulge the name of the person responsible for the infection under pain of losing custody of the rest of their brood. Too bad NYC officials are gutless and in the pocket of these people.
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Agree. It wasnt airborne. The parents know who did it/caused the harm. If parents are threatened with losing their kids, they will talk. And if they talk, the mohels will be much more wary and careful and refrain from being so careless. We know there are halachic ways to handle this without MBP, and the chassidim pushing this (i.e., David Niderman) ought to think of how they find ways around taking interest like via hetter iska or if they want to go to the extreme of the letter of the law, insist all members of community become more makpid in dealing honestly in business. Enough of this shush shush, giggle, giggle, lets pretend the goyim dont know what they are talking about.
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