If you must opt for circumcision make sure you avoid the threat of herpes

Alf is often vexed by newspapers giving their readers medical advice that looks sound, except that lots of other experts say maybe it is not such good advice.

The NZ Herald has an example today, advising readers of a study which says circumcision reduces the risk of infections, cancer and other painful conditions and should be routinely carried out on newborn boys.

Because Alf is a few years past being a newborn boy, obviously this advice is too late for him. Too late for his sons too.

But maybe the next crop of grandsons might benefit.

The Herald notes that about 10 per cent of New Zealand’s male babies are circumcised.

If you want the procedure done, however, you have to pay for it yourself. The Government pays only for medical reasons, such as frequent infections.

But recent research by 12 medical experts, led by Sydney University professor of medicine Brian Morris, claimed evidence in favour of infant circumcision was overwhelming.

Their report showed that in uncircumcised infants, the risk of urinary tract infection and kidney inflammation was 10 times greater than those circumcised.

Later in life the uncircumcised had a higher risk of prostate and penile cancer, and for HIV and syphilis the risk was three to eight times greater.

But if you find the case for circumcision compelling, make sure the job is done in a hospital or clinic.

Alf says this having learned that a baby died at a New York hospital a few months ago after contracting herpes from a controversial circumcision ritual.

The infant died at Maimonies Hospital in Brooklyn, where the cause of death was listed as “disseminated herpes simplex virus Type 1, complicating ritual circumcision with oral suction,” according to the New York Daily News.

The Brooklyn District Attorney’s office is looking further into the case, according to a report in the Jewish Week.

Fair enough, too, because the boy is the second New York area infant in recent years to die from complications related to the Orthodox Jewish ritual of metzitzah b’peh.

Alf is seriously bothered about this ritual, although he admits his understanding of it might be a tad simplistic.

The mohel – a Jewish man who performs the ritual of brit milah on a baby boy after he is born – places his mouth on the freshly circumcised penis to draw blood away from the cut.

At least, that’s what happens according to the New York City Department of Heath.

But it seems to be a dubious way of doing things.

Another infant died in 2005 after contracting herpes from a rabbi who performed the procedure.

At least three infants are thought to have contracted the disease from the same mohel in 2004, but when city officials denounced the practice, Haredi leaders became defensive and alleged government shouldn’t impede on a religious ritual, according to the Jewish Telegraphic Agency.

The mohel in question disputed claims that he was the cause of the infection.

Fair to say, the direct mouth to skin contact isn’t the only option.

The Rabbincal Council of America supports using a sterilized tube to suction the wound and in a news release said this method “absolutely fulfills the precept whilst placing the infant and mohel at no additional risk.”

American Jews are now arguing the toss over the best way to carry out the practice.

It looks like a similar debate might be shaping up in this country on the strength of the Aussie research.

Dr Rosemary Marks, president of the NZ Paediatric Society, said there were some “small benefits” to circumcision, but not enough to warrant funding the procedure.

“I think that’s a very long bow to draw … compared to the other priorities that we have for health care, personally this would be very low on my list of priorities.

“I don’t think this is something that should be offered routinely in the New Zealand public health system.”

Alf can buy into this line of thinking, although circumcision will slice a nice chunk out of your cash flow – people wanting it done to their sons for religious or cultural reasons must pay about $1000 for a surgeon to do the job at a private hospital.

You can try a GP, who will charge around $300 to perform circumcisions, according to the Herald.

But here’s the thing –

After reviewing evidence on circumcision in 2010, the Royal Australasian College of Physicians declared “there is no medical indication for routine neonatal circumcision”.

Auckland paediatric surgeon James Hamill said that was the consensus among paediatric surgeons.

Benefits of circumcision had to be viewed in context, he said. “We don’t live in a desert, or in a country with a high rate of HIV, so in different cultural or geographical context it may be different.”

Professor Morris disagrees, describing the current view of Australasian health authorities towards circumcision as “blinkered ideology”.

Alf is tempted to think his grandsons’ willies will be better cared for by blinkered doctors who leave them intact than unblinkered doctors who want a slice of the action.

He above all is glad he has no religious reasons to take his grandsons anywhere near mohels with mouth infections.


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