Neonatal genital herpes simplex virus type 1 infection after Jewish ritual circumcision: modern medicine and religious tradition.

Benjamin Gesundheit, Galia Grisaru-Soen, David Greenberg, Osnat Levtzion-Korach, David Malkin, Martin Petric, Gideon Koren, Moshe D. Tendler, Bruria Ben-Zeev, Amir Vardi, Ron Dagan, Dan Engelhard

    Research output: Contribution to journalArticlepeer-review

    39 Scopus citations

    Abstract

    OBJECTIVE: Genital neonatal herpes simplex virus type 1 (HSV-1) infection was observed in a series of neonates after traditional Jewish ritual circumcision. The objective of this study was to describe neonate genital HSV-1 infection after ritual circumcision and investigate the association between genital HSV-1 after circumcision and the practice of the traditional circumcision. METHODS: Eight neonates with genital HSV-1 infection after ritual circumcision were identified. RESULTS: The average interval from circumcision to clinical manifestations was 7.25 +/- 2.5 days. In all cases, the traditional circumciser (the mohel) had performed the ancient custom of orally suctioning the blood after cutting the foreskin (oral metzitzah), which is currently practiced by only a minority of mohels. Six infants received intravenous acyclovir therapy. Four infants had recurrent episodes of genital HSV infection, and 1 developed HSV encephalitis with neurologic sequelae. All four mohels tested for HSV antibodies were seropositive. CONCLUSION: Ritual Jewish circumcision that includes metzitzah with direct oral-genital contact carries a serious risk for transmission of HSV from mohels to neonates, which can be complicated by protracted or severe infection. Oral metzitzah after ritual circumcision may be hazardous to the neonate.

    Original languageEnglish
    Pages (from-to)e259-263
    JournalPediatrics
    Volume114
    Issue number2
    DOIs
    StatePublished - 1 Jan 2004

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health

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