Don Weiss ’79 tries to keep infectious disease
at bay for 8 million people
By Sherri Kimmel
Art-deco eagles guard the stone exterior of the sprawling New York Department
of Health building on Worth Street, a 10-minute walk from the eerie gap in the lower
Manhattan skyline that was once the World Trade Center. Inside, phalanxes of tough-talking
guards go about their security details very thoroughly. Bags are screened, IDs checked
and photos taken of every visitor. Before heading upstairs you adhere a ghostly image
of yourself to your lapel, below which is typed your name and the date of your visit.
The
man who recommended all of this vigilance is waiting upstairs—well, not really
waiting. He’s pounding out a grant proposal to the Centers for Disease Control.
As medical director of the Surveillance Unit of the Communicable Disease Program for
the five boroughs of New York, Weiss is a man who doesn’t waste a moment. He
directs a staff of 40 medical professionals/sleuths seeking the cause and containment
of the disease du jour. An example he mentions features a weird strain of salmonella
that originated with some funky chicken served at a wedding reception. Once a lab,
doctor or hospital reports an unusual case, Weiss and his staff go on the prowl. They
interview the victim, find out where he or she has been and with whom. They interview
other wedding guests and find out that those who ate the chicken took sick, while those
who stuck with pasta didn’t.
“We want to prevent transmission to other
people, so we find out what happened to cause the spread, then recommend and implement
control measures,” Weiss explains. “We
find out what happened in the production of the chicken Cordon Bleu, working with the
bureau of investigation and the restaurant investigators.” In this sample case,
investigation reveals that the refrigerator in which the chicken was stored prior to
prep had a temperature above the required 40 degrees Fahrenheit. The remedy is the
kitchen will be closed until the refrigerator is repaired.
For each investigation,
says Weiss, “there are people who do interviews, and we all
go over and interpret [findings] together and make decisions. It’s a collaborative
effort.”
Depending upon the rarity of the disease, one or dozens of infected people
can signify an outbreak.
“A single case of smallpox or the plague is an outbreak
in New York City,” notes
Weiss. “A couple of Legionnaires cases would be an outbreak. There isn’t
a simple, straightforward definition. I’m surprised we don’t have more
outbreaks in New York City than we do.”
Frightening diseases, such as SARS and
West Nile Virus, also fall under Weiss’s purview.
And since 9/11, he’s not only been handling traditional surveillance of diseases
that are not deliberately dispersed in the population, but also syndromic surveillance,
which covers bioterrorism. “Since 9/11 there has been a big influx of money to
public health, under bioterrorism.”
More money isn’t necessarily good for
public health, though, if it is concentrated in one area, he says. Containing a disease,
such as tuberculosis, and taking it off the front burner also can be bad, because lack
of federal and local health-department funding can sideline the vigilance needed to
detect and control a disease.
“The better you do your job, the less funding you
have to do your job,” Weiss
says. Doctors who no longer possess the know-how to diagnose a disease that was thought
eradicated also can contribute to its revival.
Weiss came to epidemiology after working in pediatrics,
following a decision not to pursue a Ph.D. in chemistry, his major at Dickinson. After
earning his M.D. at the New Jersey Medical School, Weiss worked in a mobile health
care unit for homeless children around New York City that was co-founded by musician
Paul Simon and physician Irving Redlener. Weiss moved to St. Louis in 1993 and earned
a master’s in public health while working as a pediatrician
and with the public-health department. Four years ago he returned to his home city
of New York and his current job with what he calls “the largest public-health
department in the world, as far as cities and states go.” (He is one of more
than 6,000 employees.) But disease control is not his only interest.
He’s an avid
photographer—landscapes in the Ansel Adams mode as well as portraits
of children that he saw as a clinician. And, though the only previous writing he’d
done was scientific, he is now halfway through a novel about a fictitious Midwestern
city where a disease takes hold. When asked if it will be called Outbreak, he shakes
his head and says, “Dustin Hoffman already did that movie a couple of years ago.”
Certain
that he’ll finish the manuscript but uncertain of its salability, Weiss is
content with his day job where he works with “smart, motivated” colleagues
and has enough staff to handle an outbreak. Being an epidemiologist has become more
hip in the last few years, he says, citing proof:
“You know your career has made
it when it gets to be a cartoon in The New Yorker.”
