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Standing Tall for Public Health
by Eve Jacobs

Stanley Weiss, MD, professor of preventive medicine and community health at UMDNJ-New Jersey Medical School and associate professor of quantitative methods at UMDNJ-School of Public Health.

Finding import in number patterns may sound like the underpinnings of numerology, but it is also the basis of scientific endeavors to stem killer diseases. While most physicians battle disease on a one-to-one basis, a small percentage take a broader, more mathematical approach, working to subdue its ravages by studying a disease's frequency, distribution and causes in a particular population. Their ultimate goal is to use the information to prevent future onslaughts, or at the very least, to minimize a disease's impact.

So, while you don't find Stan Weiss in a clinic or surgical suite, or making his way through a waiting list of anxious patients, his role in stamping out disease is unequivocal. A Harvard-educated MD who completed fellowships in medical oncology and epidemiology with the National Cancer Institute, you'll find him standing at the crossroads where clinical medicine meets research. He is the interface, chasing down the numbers, collecting volumes of information and making sense of it, and finally dispensing the data in usable format for the scientific, as well as general, communities, so that it can be applied to change laws and practices governing "public health," and to convince individuals to change their behaviors and health professionals to change their practices.

With more than 25 years in the field, his major interests include HIV/AIDS, asthma and cancer. Early in his career, Weiss took to the streets to gather data on the mysterious and steadily mushrooming problem of AIDS. Weiss helped to pin down that the HIV virus was the disease's cause. In 1985, the prevailing notion was that few HIV-positive persons would develop AIDS. In February of that year Weiss was the senior author of an article in the New England Journal of Medicine reporting high - and rising - rates of AIDS emanating from those infected with HIV.

When AIDS started making its way into the heterosexual community, confusion and fears about its spread were flying out of control. Weiss was among the pioneers in the early to mid-1980s who pulled up their shirt sleeves and went to work gathering much-needed data from groups that were difficult to identify and next-to-impossible to follow long-term. He documented the first instances of HIV transmission from a woman to a man, and from a woman to a woman. Weiss conducted the studies that uncovered the first U.S. case of HIV transmission to a health care worker by needlestick and the first instance of HIV transmission to a research worker, findings that led to widespread changes in workplace regulations and practices world-wide. He obtained a $13.8 million contract from the National Institute of Allergy and Infectious Diseases which focused on the transmission of HIV by heterosexual sexual contact. The study followed couples - both urban and suburban - in which one person was HIV positive and one HIV negative at the time of enrollment in the research project. The goals were to determine the rate of transmission of the virus, as well as identifying factors which seemed to put an individual at high risk of becoming infected or which protected against infection.

His leadership roles during these periods earned him a national, as well as international, reputation. He also led critical early studies of the related human retroviruses HTLVII and HIV-2. His work expedited screening of donated blood for HIV, and then for these agents as well. In April 1994, he organized the "Sixth International Conference on Retrovirology: HTLV," bringing hundreds of virology experts from around the world to Absecon, NJ, further cementing his growing reputation as both a solid scientist and someone whose focus and organizational skills could make things happen.

From AIDS to asthma may sound like a long jump, but, in fact, it's not even much of a leap. The chronic respiratory disorder has taken hold with a vengeance, particularly in urban areas, and no one really knows why. Getting a handle on the number of those affected and rooting out the reasons for the rising incidence - through integrating clinical, laboratory, epidemiologic and behavioral sources of data - are what Weiss does best. He has designed and carried out several studies looking at the link between environmental contaminants and asthma in children, particularly those living in cities, where fumes from traffic and idling vehicles, as well as industrial pollution, are major issues.

In 1997, he was appointed the epidemiologist of the UMDNJ-New Jersey Medical School Asthma and Allergy Research Center and in 2000 he joined the Pediatric/Adult Asthma Coalition of NJ. His most recent asthma studies look at three western Warren county towns that seem to have unusually high rates of childhood asthma and other respiratory complaints. Parents believe that air pollutants are the cause and they are pointing the finger at a local power generating plant. Weiss and his partner, Clifford P. Weisel, PhD, professor of environmental and community medicine at UMDNJ-Robert Wood Johnson Medical School, designed and initiated a study in which students with physician-diagnosed asthma agreed to submit data on any breathing problems, medications and dosages used, and general health status via computer on a daily basis for several months. The researchers collected the data and are using it to help identify the correlation, if any, between changing levels of environmental pollutants, such as sulfur dioxide, and worsening asthma symptoms. The study is the first-of-its-kind clinical research where all data collection was done via the Web. September marks the beginning of the third year of CDC funding for a related project that is examining whether there is an association between school absenteeism and environmental pollutants.

Cancer control and prevention are now uppermost in Weiss' line of vision. He was one of the writers of the 287-page Comprehensive Cancer Control Plan - Report to the Governor, published in July 2002. Issued by the State's Task Force on Cancer Prevention, Early Detection and Treatment in New Jersey, it lays the groundwork for multiple workgroups to grapple with the state's cancer issues and includes a five-year plan for implementing recommendations. The implementation phase was begun in 2002. Strategies include prevention education, promoting early detection and making state-of-theart treatment more readily available to all New Jerseyans. As part of this effort, in conjunction with Peg Knight, RN, the executive director of the state's Office of Cancer Control and Prevention, Weiss has overseen the development of the most comprehensive databases ever put together on New Jersey's health resources for cancer, and of detailed capacity and needs assessments in each county. As chair of the evaluation committee of the task force, his mission includes an ongoing evaluation of the state cancer plan.

Although the well-being of his home state is first and foremost in Weiss' mind, the national scene is high on his list of priorities. He served two years as program chair for the epidemiology section of the American Public Health Association (APHA), six years as a governing council representative and two years on its nominating committee. He currently serves on the science board of the APHA, which sets the organization's policy for science and business. As chair elect of the epidemiology section, he will assume the chair in November 2005. He was co-chair of the infectious disease epidemiology track for the First North American Congress of Epidemiology and is currently one of 10 core planners for the Second North American Congress in June 2006. The three lead sponsors of the conference are the epidemiology section of the APHA, the American College of Epidemiology and the Society for Epidemiological Research.

For his unwavering dedication to guarding the public's health in the Garden State and beyond, Stan Weiss is recognized as one of America's "top docs."