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NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE Mary T. Bassett, MO, MPH Health Commissioner ORDER OF THE COMMISSIONER WHEREAS, on or about December 2015, the New York City Department of Health and Mental Hygiene (“Department”) was notified that an infant tested positive for herpes simplex virus type 1; and WHEREAS, on DecemberffJ2015, and prior to being diagnosed with herpes simplex virus type I, the infant was circumeised by you; and WHEREAS, it has been reported to us that in the course of circumcising the infant you directly applied your mouth to the infant’s circumcision wound, as part of a practice known as direct orogenital suction; and WHEREAS, using a laboratory requisition form supplied to you by the Department, you were tested serologically under an assigned number rather than your name for herpes simplex virus type 1 infection; and WHEREAS, results of said serologic test were reported to the Department as positive for herpes simplex virus type 1 infection; and WHEREAS, herpes simplex virus is a potentially life threatening disease when occurring in an infant that can be transmitted from one person to another via contact with oral fluids such as saliva, including direct orogenital suction at the time of circumcision; and; WHEREAS, pursuant to the Health Code § 3.07, no person shall fail to do any reasonable act or take any necessary precaution to protect human life and health; and WHEREAS, in accordance with Health Code § 11.03(e), the Department is specifically authorized to take measures to prevent morbidity or mortality; and WHEREAS, | find that performance of direct orogenital suction during infant circumcision without knowing whether you are also transmitting herpes simplex virus type 1 infection constitutes a danger to life and health of such infants THEREFORE, YOU ARE HEREBY ORDERED, to cease and desist from performing direct orogenital suction or from otherwise allowing your mouth or oral fluids to come in contact with the circumcision site on any infant that you circumcise, or whose circumeision you attend, in the City of New York until you have undergone testing for herpes simplex virus type | antibodies in a manner prescribed by the Department, and such testing is reported as negative, or Page 1 of 2 until such time as the Department determines that your performance of such procedure presents no risk to the life or health of any child. In order to arrange testing in the manner prescribed by the Department, you may contact Demetre Daskalakis, M.D, M.P.H., Acting Deputy Commissioner for Disease Control, New York City DOHMH, 42-09 28" Street, Long Island City NY 11101-4132; telephone: 347-396- 2536; email: ddaskalakis@health.nyc, gov; or fax: 347-396-2558. If you wish to contest (object to) this Order, please contact Thomas G, Merrill, General Counsel, New York City DOHMH, 42-09 28" Street (WS 14-38), Long Island City NY 11101- 4132; email: unerrill @liealth.nyc.gov; telephone: 347-396-6116; fax: 347-396- 6087, within three (3) business days of receiving this Order, and provide a statement of the reasons for your objection to this Order. pact, _3/(7]2017 WARNING Failure to comply with an Order of the Commissioner of Health and Mental Hygiene is a violation of § 3.05 of the New York City Health Code and a misdemeanor, for which you may be subject to civil and criminal fines, forfeitures and penalties, including imprisonment. Date and time of delivery: Person receiving Order: Signature Delivered by: Print Name. Tide Page 2 of 2

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