Thursday, October 23, 2014 Tishri 29, 5775

Penn Researchers Examine Controversial Circumcision Ritual

July 31, 2014 By:
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Brian Leas of the Center for Evidence-based Practice at the University of Pennsylvania
A pair of University of Pennsylvania researchers who spent several months reviewing clinical studies of a practice associated with ritual circumcision in the fervently Orthodox community did not set out to shape public policy, according to Brian Leas, one of the researchers.
 
Rather they were responding to Penn physicians who were looking for recommendations for care, said Leas, a modern Orthodox research analyst at Penn’s Center for Evidence-based Practice. 
He and fellow researcher Craig Umscheid examined 30 reported cases from 1998 to 2012 of babies who were infected with the herpes simplex virus 1 through the ritual procedure in which a mohel uses direct oral suction during the bris.
 
They determined, in a study published July 23 in Journal of the Pediatric Infectious Diseases Society, that there is a risk associated with the procedure — two babies died over the last decade after being infected with the virus — but also stated that further research is needed to determine how great that risk actually is. 
 
With what he now knows, Leas said, a pediatrician who got a call from an ultra-Orthodox family worried about their 2-week-old son with symptoms could address the possibility of the virus much sooner if the pediatrician was aware of the cultural practice of that kind of circumcision.
 
 “It’s not our job to make recommendations about policy considerations and what a public health agency should do or whether a family should or shouldn’t do this.”
 
The practice,  known as “metzitzah b’peh,”  has sparked significant controversy, particularly in New York where the city’s health department estimates more than 3,000 such circumcisions are performed annually. Among those, one baby died in 2004 and another in 2012 because of the virus, and in both cases, circumcision with oral suction was suspected of being the source.
Some have called for banning the procedure or for testing mohels for the virus.
 
Leas said he is not sure of the number of such circumcisions performed in the Philadelphia area, but he suspects the practice is extremely rare here.
 
“I believe that the Jewish community should recognize that there is a concern and do the best they can to avoid those risks,” said Leas. “It happens frequently in New York; in other communities, it doesn’t happen nearly as often. I don’t know that the risk is so significant that we need to have massive public activity” in response to it.
 
David Kushner, a friend of Leas’ who lives near him in the Rhawnhurst section of Northeast Philadelphia, said he had no misgivings about a mohel performing the ritual on his son,Yoseph Chaim Simcha, who is now 5 — despite growing community concern.
 
He pointed to the data that shows that 1 in 3,500 babies in the general population contract the virus each year, according to Boston Children’s Hospital, compared to the 30 reported cases over 14 years examined in Leas’ study, among the thousands of such circumcisions performed each year. 
 
“As an Orthodox Jew, for me to deviate from the mesorah, from the tradition, it takes a convincing threshold,” said Kushner, who manages a wedding hall in Lakewood, N.J. “And honestly, I don’t see that argument out there right now.” 

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