Ultra-Orthodox Jews criticised over circumcision practice

Dear Editor:

The risks of infant circumcision go far beyond infection with herpes as happened in New York.¹ In the late 19^th early 20^th 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