The Solution is a Solution

Genital neonatal HSV-1 infection due to ritual circumcision occurs in small numbers each year. HSV-1transmission via asymptomatic shedding sometimes occurs when the traditional method is used, which include direct contact of the oral mucosa with the glans penis. The aim of this study was to find a practice that would reduce infection and be accepted by all streams in Judaism. We found that several over-the-counter oral rinse solutions are virucidal to herpes simplex and we focused specifically on Listerine (brand name cool mint or fresh burst) due to published data indicating efficacy in eliminating contagious HSV-1 from saliva following 30 seconds of rinsing. In our findings Listerine reduced the infectivity of spiked virus by more than 4 orders of magnitude after 30`` of incubation. To ensure that residues of Listerine, left in the mouth after rinsing, will not harm the open wound we measured the minimal concentration of Listerine that is cytotoxic to living cells and found that 10 percent of Listerine in growth media was harmless. In a different experiment we measured the cytotoxicity of saliva collected after rinsing with Listerine followed by a second rinse with water. The saliva had no toxicity to growing cells even after 1 hour of incubation. Therefore, it is best to follow the rinse of Listerine, with an additional rinse of water. Since Listerine was proved to eliminate virus infectivity it seems reasonable to assume that adopting this practice will reduce the risk of infection without causing harm to the open wound itself. The impact of the suggested practice on the prevalence of HSV-1 infection due to circumcision will become clear in the following years.