The New York City Department of Health received a report within the last week of an infant with symptoms of neonatal herpes and the case is currently under investigation, The Jewish Week has learned. (By law, such reports must be made within 24 hours of a diagnosis).
While the health department could not confirm where the report came from or whether it involved the circumcision ritual metzitzah b’peh, a source in the medical community told The Jewish Week that a suspected case of neonatal herpes related to metzitzah b’peh, or oral suction, has been treated at Maimonides Hospital within the past week.
Eileen Tynion, a spokeswoman for Maimonides, told The Jewish Week, “we are bound by federal law (HIPAA) and can neither confirm nor deny the presence of any patient in our hospital.”
This case comes on the heels of revelations that four other infants who had undergone the controversial circumcision rite of metzitzah b’peh were treated for neonatal herpes, two in Rockland County in 2009 and two more recently in New Jersey.
According to the Rockland County health commissioner, Dr. Joan Facelle, in neither of the Rockland County cases was the health department able to make a link to a particular mohel because the mohel’s identity could not be confirmed. Both of the infants were treated and survived.
New York City authorities currently investigating the September herpes-related death of an infant who underwent metzitzah b’peh have also been unable to confirm the identity the mohel.
According to a source with knowledge of the investigation, the family has “closed ranks” around the mohel and members of the community are saying that the baby died “because of the mother not caring for him properly.”
The Jewish Week was privy to one recent conversation between a mohel and a community member in which this same allegation was also made by the mohel.
The Rockland County cases have raised a red flag because Rabbi Yitzchok Fischer, a mohel who has already been linked to four neonatal herpes infections (including one death) and has been under an order banning him from performing the ritual in New York state since 2007, lives in Rockland County.
While, according to Facelle, Rabbi Fischer was “certainly … well aware” of the order at the time, The Jewish Week learned that Fischer is still scheduling brises with metzitzah b’peh in Rockland County, though it has not been established that he was involved in the 2009 cases.
Meanwhile, the Forward has reported that two Jewish infants in New Jersey were also treated “within the last year or two” for neonatal herpes after undergoing metzitzah b’peh, according to Dr. Margaret Fisher, chair of pediatrics at Monmouth Medical Center.
Unlike in New York state, which in early 2006 required that cases of herpes in infants aged 60 days or younger be reported to the health department, New Jersey does not list neonatal herpes among its list of communicable and reportable diseases. As such, it is impossible to know how many metzitzah b’peh-related cases may have occurred in the state, which is home to the large haredi community of Lakewood, among others.
According to a 2009 article in the New England Journal of Medicine, untreated neonatal herpes simplex virus is associated wih a 40 percent survival rate, and even with the early initiation of high-dose intravenous acyclovir therapy, it can result in “considerable disability among survivors.” The neonatal herpes virus can spread to the brain and central nervous system causing encephalitis and meningitis and leading to mental retardation or cerebral palsy. Herpes can also spread to internal organs, such as the liver and lungs.