Wednesday, September 26, 2012

Herpes Simplex Virus Infection Following Circumcisions that Included Direct Orogenital Suction

This report in the MMWR caught my eye. An outbreak of Herpes Simplex Virus (HSV) occurred in 11 newborns and resulted in 10 hospitalizations and 2 deaths. 

The cause was attributed to ritual circumcision that involved an ultra-Orthodox Jewish practice known as metzitzah b'peh, in which the circumciser (mohel) places his mouth directly on the newly circumcised penis and sucks blood away from the circumcision wound (direct orogenital suction). 

In the cases where typing was performed in the outbreak, the isolates were HSV-1 (oral herpes). Oral contact with a newborn's open wound risks transmission of HSV and other pathogens.

As circumcision is a surgical procedure and should be performed under sterile conditions. Orogenital suction should be avoided, for obvious reasons.

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