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Ultra-Orthodox Jews criticised over circumcision practice

BMJ 2006; 332 doi: http://dx.doi.org/10.1136/bmj.332.7534.137 (Published 19 January 2006) Cite this as: BMJ 2006;332:137

Circumcision and Methicillin-Resistant Staphylococcus Aureus: A Recipe for Disaster

Dear Editor:

The risks of infant circumcision go far beyond infection with herpes as happened in New York.1 In the late 19th early 20th centuries, fatal infections of the circumcision wound with tuberculosis, diphtheria, and Staphylococcus aureus were reported.2-5

The introduction of antibiotic therapy in the late 1940s greatly reduced the risks associated with bacterial infection through the portal-of-entry created by the open circumcision wound. However, the epidemic of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), which is resistant to most antibiotics, threatens to return newly-circumcised baby boys to the perilous situation of the pre-antibiotic era.6

The risk of infection extends beyond the operating theatre because caregivers, who may be carriers of CA-MRSA, may infect the infant.7 Circumcised newborn males have a high risk of staphylococcus infection.8 For example, Annunciato & Goldblum reported post-circumcision staphylococcal scalded syndrome.9 Infection with more virulent CA-MRSA, however, increases the risk of a long-term hospital stay and even death.10

Doctors Opposing Circumcision has prepared a literature review regarding the increased risk posed by CA-MRSA to newborn circumcised boys.11 We urge hospital administrators and public health authorities in those nations that still perform non-therapeutic social circumcision of male infants to suspend the performance of that medically-unnecessary operation until such time as an effective treatment for CA-MRSA infection is developed. Action should be taken before disaster occurs.

George Hill

Vice-President for Bioethics and Medical Science

Doctors Opposing Circumcision

Suite 42

2442 NW Market Street

Seattle, Washington 98107-4137

Web: http://www.doctorsopposingcircumcision.org

References

  1. Tanne JH. Ultra-Orthodox Jews criticised over circumcision practice BMJ 2006;332: 137. [Extract]
  2. Holt LE. Tuberculosis acquired through ritual circumcision. JAMA 1913;LXI(2):99-102. [Full Text]
  3. Reuben MS. Tuberculosis following ritual circumcision. Arch Pediatr 1917; XXXIV:186-90. [Full Text]
  4. Rosenstein JL. Wound diphtheria in the newborn infant following circumcision. J Pediatr 1941;18:657-8. [Full Text]
  5. Sauer LW. Fatal staphylococcus bronchopneumonia following ritual circumcision. Am J Obstetr Gynecol 1943; 46: 583. [Full Text]
  6. Chase M. Defying treatment, a new virulent bug sparks health fears. The Wall Street Journal, New York, Friday, Januany 20, 2006:A1
  7. Payne MC, Wood HF, Karakawa W, Gluck L. A prospective study of staphylococcal colonization and infections in newborns and their families. Am J Epidemiol 1966:82:305-16.
  8. Thompson DJ, Gezon HM, Rogers KD, et al. Excess risk of staphylococcus infection and disease in newborn males. Am J Epidemiol 1965;84(2):314-28. [Abstract]
  9. Annunziato D, Goldblum LM. Staphylococcal scalded skin syndrome. A complication of circumcision. Am J Dis Child 1978;132(12):1187-8. [Full Text]
  10. Noskin GA, Rubin RJ, Schentag JJ, et al. The burden of Staphylococcus aureus infections on hospitals in the United States: an analysis of the 2000 and 2001 Nationwide Inpatient Sample Database. Arch Intern Med 2005;165:1756-61. [Abstract]
  11. Epidemic Methicillin-Resistant Staphylococcus Aureus: Dramatically Increased Risk for Circumcised Newborn Boys. Seattle: Doctors Opposing Circumcision, 2005, 2006. [Full Text]

Competing interests:
None declared

Competing interests: No competing interests

22 January 2006
George Hill
Vice-President for Bioethics and Medical Science
Doctors Opposing Circumcision, Suite 42, 2442 NW Market Street, Seatle, Washington 98107-4137, USA
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