Albany, NY - Rabbis, State Sign Health Rules For Metzizah B'peh Circumcision Ritual

Albany, NY - Commissioner Antonia Novello, in a pink suit and gold jewelry, and a sea of rabbis with long beards, black suits and hats signed a new protocol Monday that attempts to respect both an ultra-Orthodox Jewish ritual and public health concerns.

The protocols are aimed at preventing the spread of herpes through the practice of metzizah b'peh, in which the circumcision wound is ritually cleaned by sucking out the blood and spitting it out.
The policies stem from seven cases of neonatal herpes connected to the ritual. They included one child who suffered severe brain injury from the virus and another who died.
Last year, the city's health commissioner, Dr. Thomas Frieden, pushed to halt the practice. Jewish religious leaders lambasted the city for trying to halt a centuries-old practice, while the city came under fire from those who accused it of pandering to a small group at the expense of public safety.

By January, prominent rabbis had sought help from a higher power -- the state Department of Health.
Rabbis and Novello lauded the protocols Monday as a landmark step toward meshing religious and public health needs.

The new state guidelines require mohels, or anyone performing metzizah b'peh, to sanitize their hands like a surgeon, removing all jewelry, cleaning their nails under running water and washing their hands for up to six minutes with antimicrobial soap or an alcohol-based hand scrub.
The person performing metzizah b'peh also must clean his mouth with a sterile alcohol wipe and, no more than five minutes before it, rinse for at least 30 seconds with a mouthwash that contains 25 percent alcohol.
The circumcised area must be covered with antibiotic ointment and sterile gauze after the procedure.
In addition to the rabbinical policies, the state Health Department also added neonatal herpes to the list of diseases health care workers are required to report to state officials.
If a baby who underwent metzizah b'peh does contract herpes, the mohel, the infant's parents and health care workers will be tested. If the mohel has the same viral strain as the baby, the mohel will be barred from conducting any future circumcisions.

The detailed policy was hammered out over monthly meetings on Sunday nights out of respect for the Jewish Sabbath, with rabbis traveling between Albany and New York City, and occasionally phoning from Israel. Novello said she read the Talmud and the writings of the rabbi and philosopher Maimonides. The Jewish leaders said they read more scientific journals then they could count.
Novello said she treated the rabbis with the same respect she would treat Catholic cardinals. The rabbis, in turn, seemed charmed and entertained by the woman who called them "my rabbis" and greeted them with a hearty Hebrew "Shalom."
Novello suggested each rabbi sign the protocol, even those who didn't attend the meetings, so they could tell their congregations that they signed on like everyone else.

Rabbi David Niederman, the executive director of the United Jewish Organizations of Williamsburg, Brooklyn, and a member of the Central Rabbinical Congress of the USA and Canada, said the issue wasn't about a lack of understanding, but about "not appreciating. People, even those who aren't Jewish, should appreciate the fact that this is a religion that's been around for thousands of years."