Dear Rabbi Letter

May 8, 2006

Dear Rabbis:

I want to thank all of you for coming to Albany over the past few months to discuss our mutual interest in finding an acceptable solution to the issues surrounding metzizah b'peh and their perceived complications.

The meetings have been extremely helpful to me in understanding the importance of metzizah b'peh to the continuity of Jewish ritual practice, how the procedure is performed, and how we might allow the practice of metzizah b'peh to continue while still meeting the Department of Health's responsibility to protect the public health. I want to reiterate that the welfare of the children of your community is our common goal and that it is not our intent to prohibit metzizah b'peh after circumcision, rather our intent is to suggest measures that would reduce the risk of harm, if there is any, for future circumcisions where metzizah b'peh is the customary procedure and the possibility of an infected mohel may not be ruled out. I know that successful solutions can and will be based on our mutual trust and cooperation.

I have received your letter dated April 10, 2006. In this letter the members of the rabbinical council acknowledge that much progress has been made; and both parties, the Department of Health (DOH) staff and the Rabbinical Council, continuously have demonstrated a spirit of cooperation which has been instrumental in helping us deal with this sensitive public health issue.

As you have pointed out, we have accomplished much, and we need to be grateful for this progress. At this time, the DOH is in the process of proposing to the Public Health Council of New York State two health initiatives in connection with neonatal care:

  1. Designation of herpes infection in infants aged 60 days or younger (neonatal herpes) as a communicable disease, reportable to local health department and then to the State.
  2. Endorsing the Department of Health's new statewide standard of care: a) All newborns who undergo a medical or surgical procedure after birth, should be seen by a trained health care professional within 3-10 days after the procedure, or immediately if any complications develop.

Both of these health initiatives will be presented for final implementation at the next New York State Public Health Council meeting on May 12, 2006.

Finally, I am enclosing for your evaluation: 1) circumcision protocol to prevent neonatal herpes transmission; and, 2) herpes simplex virus in the newborn information page.

This last one after your evaluation and comments will need to be distributed to mothers of male newborns in the congregation.

Again, I want to thank you for addressing these challenging issues in the spirit of finding a solution that meets both the religious covenant and our obligation as a health department to protect public health. I look forward to your response to these new proposals and to further discussion with you when we next meet.

Shalom,

Antonia C. Novello, M.D., M.P.H., Dr.P.H.

Commissioner of Health

cc:

1) Circumcision protocol to prevent neonatal herpes transmission

2) Herpes simplex virus in the newborn information page

3) Designation of Communicable Disease Regulation