Jesse Bering, PhD, is regular contributor to Scientific American, Slate, and other publications. He is the author of the recently released book, Why Is the Penis Shaped Like That? And Other Reflections on Being Human and The Belief Instinct, which the American Library Association named one of the “25 Best Books of 2011.” You can find him here.
For the past seven years, I’ve been in an “interpenile relationship”—I, the lesser of the two you might say, am circumcised; my partner is not. This contrast between our members is not exactly at the top of our list of concerns. But it is nonetheless interesting how my prepuce came to disappear into a medical waste bin in a bustling New Jersey hospital on some springtime day in 1975, whereas his, by contrast, has remained a fellow traveler all the long way from that tiny Mexican village where he slipped from his young mother’s womb on a chilly December morning in 1981. That womb, incidentally, belonged to a Roman Catholic. The one that I bathed in, the place in which I had my “bones and sinews knitted together,” in the words of Job, was the property of a Jew. So despite neither of us being particularly patriotic nor, certainly, religious today, the organs dangling so differently between us are nevertheless the very incarnations of our parents’ vast cultural differences.
Whatever the reasons that previous generations may have had for choosing to remove their infant sons’ foreskins, they were almost always unconvincing. All else being equal—and let me reiterate that caveat because it’s likely to go unnoticed, with some readers eagerly pointing out to me those rare cases of congenital defects in which circumcision can legitimately improve the quality of life for some males, which is of course true—all else being equal, any dubious benefits derived from religious, social, hygienic, or aesthetic reasons are clearly outweighed by the costs of male circumcision. Because of some rabbi in Hackensack shaking his head over my intact genitalia, my parents went unblinkingly along with the amputation of a fully operational, perfectly healthy, and probably adaptive body part, all to sacrifice an ounce of their son’s tender flesh to a god that he would never believe in anyway.
Today, however, all is no longer equal, and the balance between the relative risks and benefits of male circumcision has clearly shifted in the other direction. That is, it has according to the American Academy of Pediatrics, which just earlier this week put out its revised position statement on infant male circumcision. Here’s the money quote:
Systematic evaluation of English-language peer-reviewed literature from 1995 through 2010 indicates that preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure. Benefits include significant reductions in the risk of urinary tract infection in the first year of life and, subsequently, in the risk of heterosexual acquisition of HIV and the transmission of other sexually transmitted infections.
Many of our parents, it seems, may have actually made the right decision for the wrong reasons. Although the task force behind the Academy’s reassessment stopped short of advising “routine” and “universal” removal of the foreskin for all newborn males, and stressed that it remains a personal decision to be made by informed parents, its language represents an increasingly unambiguous endorsement of male circumcision among the world’s leading health organizations (including the World Health Organization and UNAIDS) . By contrast, many of the world’s leading parents remain skeptical of the findings reviewed by the Academy, questioning both the methodologies and the generalizability of studies conducted overwhelmingly with African populations, in which rates of infection are dramatically higher than those in the US. (For more information on this research, as well as a description of the physical factors responsible for the reduction of HIV acquisition in circumcised males, see my earlier discussion at Scientific American.) The more vocal “intactivists,” who’ve long been protesting what they regard as an antiquated, cruel and unnecessary ritual act against little boys that is just as abhorrent as female clitoridectomy, have also responded bitterly to this newest AAP development, seeing fresh strands in an ongoing web of conspiracy between the major health organizations, third-party insurance companies implementing the policy views of these organizations, and greedy practitioners who mislead parents about the benefits of circumcision only to reap insurance payouts for “mutilating” children’s genitals.
Vincent Racaniello is Higgins Professor of Microbiology & Immunology at Columbia University, where he oversees research on viruses that cause common colds and poliomyelitis. He teaches virology to undergraduate, graduate, medical, dental, and nursing students, and writes about viruses at virology.ws.
The detection of a new virus called XMRV in the blood of patients with chronic fatigue syndrome (CFS) in 2009 raised hope that a long-sought cause of the disease, whose central characteristic is extreme tiredness that lasts for at least six months, had been finally found. But that hypothesis has dramatically fallen apart in recent months. Its public demise brings to mind an instance when a virus *was* successfully determined to be behind a mysterious scourge: the case of HIV and AIDS. How are these two diseases different—how was it that stringent lab tests and epidemiology ruled one of these viruses out, and one of them in?
Are the silent viruses within us doing more than we know?
By Laura Kasman, as told to Veronique Greenwood
In the 1970s, doctors noticed that sometimes people with hepatitis B virus infection (HBV) would get suddenly much worse and go into liver failure, and they didn’t know why. But through hard work with what are now antiquated methods, they found out that there was another virus, very different genetically from HBV, but dependent on HBV to spread from person to person. It is called hepatitis D virus or delta agent, and it steals proteins made by HBV to get from cell to cell and victim to victim. The combination of HBV plus hepatitis D is always much more serious than HBV alone, and hepatitis D virus never occurs on its own.
This phenomenon, called viral interference, has been seen in the lab for a while, but it was generally thought to be an artifact with little or no importance in human disease. That’s because we didn’t have the technology to easily find and identify viruses in living people until recently.
The advent of PCR rewrote our understanding of viral interactions, as it did for many areas of biology. We learned that almost everyone has many silent viral infections cooking in them all the time, some that last for life and some that come and go. When the human genome was sequenced, it showed that 8% of the human genome is made up of dormant and disabled retroviruses (the kind of virus that causes AIDS). It’s as if scientists were looking for cockroaches in a big dark room and all we had was a little flashlight. For decades we followed one bug at a time, and it worked and we made progress, so we thought each one was alone. And then with PCR we found the light switch and yikes, they were everywhere! We didn’t notice most of them for so long because they cause no symptoms in most people. Read More