Many people familiar with issue of herpes transmission through metzitzah b'peh (MBP, the direct mouth-to-bleeding-penis sucking done by haredi mohels after cutting off a baby's foreskin) believe haredim will scam the new MBP agreement they made with New York City. Here's one way they might do it.
Many people familiar with issue of herpes transmission through metzitzah b'peh (MBP, the direct mouth-to-bleeding-penis sucking done by haredi mohels after cutting off a baby's foreskin) believe haredim will scam the new MBP agreement they made with New York City.
The agreement scraps the informed consent requirement the city put in place two years ago and swaps it out with a very questionable DNA testing requirement – which is voluntary and will only take place after a baby is infected, not before.
Worse yet, if the mohel in question tests positive for herpes but his strain doesn't match the baby's, he won't be banned – even though he has herpes and can transmit it to another baby and kill him. This type of herpes DNA testing produces an alarming number of false negatives, meaning actual herpes carriers who infect babies can show as a no-match to that baby. And there's also a very easy way for haredim to scam the results of those tests even further.
The de Blasio Administration touts the education about MBP's risks that will now reach haredim as a key reason to be happy about this new deal. But 10 years ago, attempts to educate the haredi community about MBP's dangers sparked haredi protests against the city.
And then we have the simple way the tests can be scammed to protect infected mohels. Capital New York reports:
…“I think this is an embarrassing political capitulation which is not based on the science or the opinions of leading experts in herpes epidemiology and clinical care,” said Dr. Jonathan Zenilman, a professor of medicine at the Johns Hopkins University School of Medicine and chief of the infectious diseases division at the Johns Hopkins Bayview Medical Center.
Zenilman signed an affidavit on behalf of the health department and last month was a go-to source when the department was looking to defend its policy to a reporter.
“I cannot speak for the health department officials, but the science is pretty clear and has been obfuscated by the interest group involved,” Zenilman said. “During the meeting of the Board of Health in 2012, which approved the informed consent rule, there was a contingent of the Board of Health which wanted to ban the practice outright.”…
…Now, the question is whether the fact that a group ignores a regulation is a good reason to change the regulation.
“I don't know the answer but I think compliance is a potential issue with either approach,” said Dr. Anna Wald. who assisted in drafting guidelines on the management of H.S.V. infection for the federal Centers for Disease Control and Prevention. She also filed an affidavit on behalf of the city's health department.
In exchange for abandoning the consent forms, the coalition of rabbis negotiating with City Hall agreed that if a baby is diagnosed with H.S.V.-1, the community would identify the mohel who performed the bris, or circumcision, and ask him to undergo testing. If the mohel tests positive for H.S.V.-1, the city's health department will test the D.N.A. of the herpes strain to see if it matches the infant's. If it does, the mohel will be banned from performing the ritual for life.
Wald believes de Blasio's policy is “in some ways…a step forward as it appears that the Orthodox community is admitting that the HSV-1 infection is a result of the ritual.” [The fact is that the haredi community is not making that admission at all. In fact, they clearly still hold the opposite – that metzitzah b’peh done properly does not transmit disease. But of course, that is clearly false. – FailedMessiah.com]
“However, it seems to me that the bar for banning an individual from performing the ritual is very high," she said in an email. "Obtaining a virus and showing that the strain is identical to that of the infected baby is not a simple task, and may be not doable without—or even with—full participation of the mohel.”
The problem with testing is that people who can transmit the virus are not always contagious. Shedding of the virus is intermittent, and swabbing would have to be done over a long period of time to a cooperative person who is not taking antivirals.
“I am not sure how you can ascertain that someone is adherent to that, especially if they are invested in an outcome that shows them to be negative for the virus,” Wald said.…