The circumciser will only be allowed to remove blood from the baby's penis with his mouth, in a type of Jewish circumcision ritual, if the parents say it is OK, the New York City Department of Health and Mental Hygiene has announced.

This type of ritual circumcision is common in some ultra-Orthodox Jewish communities. Public health authorities in New York City say there is a risk of herpes infection for the child.

The Panel, consisting of public health professionals and physicians said that removing blood with one's mouth poses a serious risk of transmitting disease. Orthodox Jewish representatives claimed the move is unconstitutional and infringes on people's religious freedoms.

Some Panel members felt that the new legislation does not go far enough - requiring parental consent did not protect the health of the baby, who has no choice in the matter.

Dr. Joel A. Foreman, who works at the Mount Sinai School of Medicine as a pediatrics professor said, "it's crazy that we allow this (ritual circumcision) to go on."

The risk of becoming infected with herpes, which is a potentially fatal infection for infants, is considerably higher if the circumciser removes blood from the baby's penis with his month. The ritual is called "Metzitzah b'peh".

Reports of babies becoming infected and dying after circumcision rituals

New York City health officials say there have been 11 reports of herpes infections linked to this type of circumcision ritual over a 7-year period (2004-2011) in New York City alone. Two of the infants suffered brain damage and another two died. According to the CDC, in the remaining cases, other evidence suggested that orogenital suction (removing blood from the penis with the mouth) caused genital infection in infants.

In a report in June 2012, the CDC wrote:

"Based on cases reported to DOHMH during April 2006 - December 2011, the risk for neonatal herpes caused by HSV-1 and untyped HSV following Jewish ritual circumcision with confirmed or probable direct orogenital suction in New York City was estimated at 1 in 4,098 or 3.4 times greater than the risk among male infants considered unlikely to have had direct orogenital suction.

Oral contact with a newborn's open wound risks transmission of HSV and other pathogens. Circumcision is a surgical procedure that should be performed under sterile conditions. Health-care professionals advising parents and parents choosing Jewish ritual circumcision should inquire in advance whether direct orogenital suction will be performed, and orogenital suction should be avoided."

Nobody knows how many babies become infected because of religious circumcision rituals across the USA every year - there are no figures on brain damage or deaths on a national scale either.

Mohelims, circumcisers in this type of circumcision ritual, say they no longer remove the baby's blood with their mouths; they also say they use sterile glass pipettes and gauze. Orthodox-Jewish rabbis stress that the procedure is safe and adheres to Talmudic codes.

Over 200 ultra-Orthodox rabbis have been told to ignore the new legislation which requires parental consent.

A number of people gathered outside the building while the panel discussed the new legislation. One of them, Rabbi William Handlre, an ultra-Orthodox Jew, said that New York City officials are lying and slandering compassionate rabbis.

In the new legislation, circumcisers will have to explain to the infant's parents in writing if they plan to remove blood from the child's penis with their mouths - for this to proceed, the parents will have to give their consent in writing. The consent form includes advice from the NY Health Department which warns of the risk of herpes infection, and the subsequent risk of brain damage or death.

The consent form that the parents send to the circumciser must be filed for 12 months after the procedure is carried out.

The New York City Health Department says there will be no spot checks or raids on mohelims and where they perform circumcisions. There are no mandatory punishments. If a circumciser does not comply with the new legislation, he will be sent warning letters and may be liable to a fine of up to $2,000.

Orthodox Jewish groups say they plan to sue the government of New York City so that the new legislation may be either reversed or blocked. The new law will go into effect in a month's time.

The New York Times wrote that Rabbi David Niederman, a Satmar Hasidic leader, as saying:

"We are convinced that this amendment will be thrown out by the courts."

According to the CDC (Centers for Disease Control and Prevention), this type of circumcision is unsafe and exposes the child to health risks. New York City officials estimate that approximately 3,600 infants are circumcised in this way every year in the city.

Health Commissioner Thomas Farley said before the Panel voted on the new legislation that this was "a very difficult issue". He added that the health department has been as un-intrusive as it can by leaving the final choice to the infant's parents.

Why is herpes in babies so dangerous?

Herpes Simplex Virus (HSV) is a highly human transmissible virus. It is passed from human-to-human by close or direct contact. The most common modes of transmission are via vaginal, anal or oral sex (mouth contact with the penis or vagina). The virus does not distinguish oral sex from oral procedures on a penis with a religious motive - the risk of transmission by removing blood from a child's sexual organ with the mouth exists. In most cases, the infected person has no symptoms and the virus remains dormant; they may not know they are infected.

Neonatal herpes simplex virus disease - when babies are infected and become ill with HSV - is linked to high morbidity and mortality. This means the risk of illness and death is much higher for babies than for adults. This is because the infant's immune system is not yet fully developed.

Many people in New York City and the rest of the USA - upon learning about this new legislation and what occurs during this type of circumcision ritual - are surprised that an adult man is legally permitted to touch a male baby's penis with his mouth under any circumstances.

Written by Christian Nordqvist