- the impact HCV is both medical and non medical

- this should have a high priority

- it is in epidemic proportions

- we still have to deal with inapparent transmission

-how do we effectively cleanup blood spills?

- prisons are an area of great concern

- we must be able to identify new IDU

- vertical transmission is of the utmost importance

-vaccine development is essential

Secondary Prevention

We need to look at the HIV/AIDs model and see what applies to HCV -prevention of initiation of drug use-what brings it on? Public Health can look at epidemiological evidence. LCDC can look at acute HCV. We must have quantitative research. We need to know the prevalence across current populations. It is possible to have cohort studies in schools. We must have a national consensus on how to deal with the drug problem. It is already possible to ID kindergarten children at risk. We do not know if it will be alcohol or drugs. We need to predict the cessation of IDU, and relapsers. And there must be more enforcement on drug busts.

1. A national strategy needs to cover initiation into drug use. Both aspects-behavioral and biomedical need to work together (this does not occur now).

2. Recreational users need to be studied as to the risk/behaviour that leads to HCV infection.

3. CBS/Heme Quebec are interested in this kind of research (as a promoter). They want to promote a healthy lifestyle to be eligible for blood donation. IVDU isn't a population that readily donates blood. Prisons are the problem. Resources are not enough to cover this. PCR testing will begin in June.

How long is HCV active in the system? CBS won't allow any former users to donate. We need new strategies that will complement existing strategies.

It is a societal problem with drug users / prisons. Rehab versus prison-in 1 study a single offender committed 1000 crimes in the previous 3 months. These included petty crimes.

Can we use STATS CAN? Survey with nested control study. Use existing structures as opposed to creating new ones. We need to use a shelter people, police, ER.,

Development of a vaccine is important but should not be at the risk of research for cure.

We need to use HCV as an educational tool in prisons. The incidence of HCV in the gay community is also relatively high. Alcohol is not well studied. The U.S. does not know what the incidence of HCV in prisons is.

The viability of HCV-we do not know how to this story the HCV in the environment.

Screening of HCV, H BV, and HIV in pregnant women in Manitoba-possible cohort study here. Recommended versus mandatory. Use of this group would require more in depth PCR/VL.

In general HCV is not always reported to Public Health. In Quebec-no, Manitoba-next month. And there is no follow-up on those infected with HCV.