Sunday, August 31, 2014

Ending the Month ZMapping Ebola in Africa

The beginning of the new month tomorrow will be bringing an exciting yet still familiar format with a new yet still similar style!

"Liberian doctor given experimental Ebola drug dies" Associated Press   August 26, 2014

MONROVIA, Liberia — A Liberian doctor who received one of the last known doses of an experimental Ebola drug has died, officials said Monday, as Canada said it has yet to send out doses of a potential vaccine that the government is donating.

Ebola has killed about 1,400 people across West Africa, underscoring the urgency for developing ways to stop and treat the disease. However, health experts warn these options have not undergone the rigorous testing that usually takes place before drugs and vaccines are approved.

The experimental vaccines are at a Canadian laboratory, said Patrick Gaebel, spokesman for the Public Health Agency of Canada, who declined to speculate how many weeks it could be before those are given to volunteers.

‘‘We are now working with the [World Health Organization] to address complex regulatory, logistical, and ethical issues so that the vaccine can be safely and ethically deployed as rapidly as possible,’’ Gaebel said.

Only six people in the world are known to have received the untested drug known as ZMapp. The small supply is now said to be exhausted and it is expected to be months before more can be produced by its US maker.

Dr. Abraham Borbor, the deputy chief medical doctor at Liberia’s largest hospital, had received ZMapp, after it was given to two Americans. After receiving medical care in the United States, they later survived the virus, which has killed about half of its victims.

A Spanish missionary priest infected with Ebola also received the treatment but died. There was no update given on the two other Liberians who took the last known available doses of ZMapp.

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"Ebola has ‘upper hand’ says US health official" by Jonathan Paye-Layleh | Associated Press   August 27, 2014

MONROVIA, Liberia — Ebola still has the ‘‘upper hand’’ in the outbreak that has killed more than 1,400 people in West Africa, but experts have the means to stop it, a top American health official said during a visit to the hardest-hit countries.

Dr. Tom Frieden, director of the US Centers for Disease Control and Prevention, was in Liberia on Tuesday and later planned to stop in Sierra Leone and Guinea. Nigeria also has cases, but officials there have expressed optimism the virus can be controlled.

‘‘Lots of hard work is happening. Lots of good things are happening,’’ Frieden said at a meeting attended by President Ellen Johnson Sirleaf of Liberia on Monday. ‘‘But the virus still has the upper hand.’’

I'm just not seeing it, sorry.

Even as Liberia has resorted to stringent measures to try to halt Ebola’s spread, frustration mounted over the slow collection of bodies from neighborhoods of Monrovia. A group of residents attached plastic ties to the wrists and ankles of one suspected Ebola victim and dragged his corpse to a busy street.

Authorities have decreed that all the dead must be collected by government health workers and cremated because contact with bodies can transmit the virus.

There is no proven treatment for Ebola, so health workers primarily focus on isolating the sick. But a small number of patients in this outbreak have received an experimental drug called ZMapp. The London hospital treating a British nurse infected in Sierra Leone, William Pooley, said he is receiving the drug.

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"US official warns Ebola outbreak will worsen" by Clarence Roy-Macaulay and Jonathan Paye-Layleh | Associated Press   August 28, 2014

FREETOWN, Sierra Leone — A third doctor has died from Ebola in Sierra Leone, a government official said Wednesday, as a leading US health official warned that the outbreak sweeping West Africa would get worse.

The disease has already killed more than 1,400 people in Guinea, Liberia, Nigeria, and Sierra Leone, and Doctors Without Borders warned that the influx of patients in Liberia, in particular, is overwhelming their treatment centers there.

‘‘I wish I didn’t have to say this, but it is going to get worse before it gets better,’’ Dr. Tom Frieden, director of the US Centers for Disease Control and Prevention, said of the outbreak at the end of a visit to Liberia, where he described the situation as dire.

Liberia has recorded the highest number of cases and deaths of any of the four countries. Doctors Without Borders said in a prepared statement that a new 120-bed treatment center in the country’s capital filled up almost immediately.

The growing number of patients means that the medical charity is not able to provide those patients with intravenous treatments, a primary way doctors keep alive people who are losing a great amount of fluid.

The group did not mention Frieden’s visit or recent visits by UN officials, but it said discussions now about international coordination are coming too late and there are countries that could make a dramatic difference if they provided more expertise and resources. It did not name the countries.

‘‘This is not only an Ebola outbreak — it is a humanitarian emergency, and it needs a full-scale humanitarian response,’’ Lindis Hurum, the Doctors Without Borders emergency coordinator in Monrovia, the Liberian capital, said in the statement.

Frieden travels next to Sierra Leone, where the loss of a third senior doctor has raised concerns about the country’s ability to fight the outbreak.

Dr. Sahr Rogers had been working at a hospital in the eastern town of Kenema when he contracted Ebola, Sierra Leonean presidential adviser Ibrahim Ben Kargbo said Wednesday.

Rogers’s death marks yet another setback for Sierra Leone, a country still recovering from years of civil war, where there are only two doctors per 100,000 people, according to the World Health Organization. By comparison, there are 245 doctors per 100,000 people in the United States.

Health workers have been especially vulnerable because of their proximity to patients, who can spread the virus through bodily fluids.

It was also leaked out that it can be transmitted by air, but the propaganda pre$$ quickly squashed that panic.

WHO has said that at least 240 health workers have been infected in this outbreak, more than in any other. One of those is an epidemiologist working with the WHO in Sierra Leone, who has been evacuated for treatment in Germany.

‘‘The international surge of health workers is extremely important and if something happens, if health workers get infected and it scares off other international health workers from coming, we will be in dire straits,’’ said Christy Feig, director of WHO communications.

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"Study finds experimental drug shows promise in fighting Ebola" by Andrew Pollack | New York Times   August 30, 2014

A new study provides strong evidence that the experimental drug given to two American aid workers stricken with Ebola in Africa really works and could make a difference in the current outbreak if more of it could be produced.

In the study, all 18 monkeys exposed to a lethal dose of the Ebola virus survived when given the drug, known as ZMapp, even when the treatment was started five days after infection, when the animals were already sick.

Moreover, the monkeys’ symptoms, such as excessive bleeding, rashes, and signs of liver toxicity, eventually disappeared. By contrast, all three monkeys in the control group died.

Experts said these were the best monkey results reported to date for any Ebola drug, raising hopes that the drug will work in people.

“I think it strongly supports that concept,” Dr. Gary P. Kobinger, the senior author of the study, said in a telephone news conference Friday, shortly before the paper was published by the journal Nature. Still, Kobinger, a researcher for the Public Health Agency of Canada, cautioned that effectiveness in monkeys was not “proof” that a drug would work in people.

The problem is that the supply of ZMapp is exhausted, according to Mapp Biopharmaceutical, the nine-person San Diego company that is developing the drug. And it is expected to take months to make more of the drug, which is produced in genetically engineered tobacco plants.

Maybe smoking would help cure you (or vitamin C)?

ZMapp came to the world’s attention early this month when it appeared to help two American aid workers stricken in Liberia and later flown to Emory University Hospital in Atlanta. The workers, Dr. Kent Brantly and Nancy Writebol, recovered and were discharged from the hospital last week.

Doctors say it is impossible to say what role ZMapp played in their recovery. Nonetheless, there has been a clamor for the drug and an ethical debate about who was entitled to the handful of treatment courses available.

This is really having a genocidal EndGame feel to it.

Some other experimental drugs have shown the ability to protect monkeys from Ebola if given shortly after infection, up to about two days. That might make such a drug useful for what is called postexposure prophylaxis.

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"Ebola survivor praises new drug

MONROVIA — A Liberian health worker who recovered from Ebola after receiving an experimental drug urged the manufacturer to speed up its production and send it to Africa, and crowds celebrated in the streets after authorities reopened a slum that had been barricaded for a week to try to contain the disease. Physician’s assistant Kyndy Kobbah was expected to be released from a hospital Saturday. It is not clear whether the drug, ZMapp, aided her recovery."

Barricaded means quarantined.

"Liberian Ebola survivor praises new drug" by Jonathan Paye-Layleh | Associated Press   August 31, 2014

MONROVIA, Liberia — Meanwhile, tensions diminished Saturday in the West Point neighborhood of Liberia’s capital after authorities lifted a blockade that had sparked unrest. Residents living in the area had feared running out of food and safe water on the peninsula.

Liberia’s president had ordered the barricade on Aug. 19 after West Point residents stormed an Ebola health center several days earlier. Residents said they did not want sick people being brought into the community, although those staying at the center were only under observation during a 21-day incubation period. Amid the melee, some protesters made off with blood-stained mattresses and other materials that could spread the Ebola virus.

I can't blame them for that, but why would they take infected material? To destroy it?

Lifting the quarantine Saturday morning does not mean there is no Ebola in the West Point slum, said Information Minister Lewis Brown. Authorities, though, are more confident now that they can work with residents to screen for the sick, he said.

‘‘They’re comfortable with the way the leadership and the community are working with the health team to make sure that the community remains safe,’’ he said.

Then the crisis is abating?

Liberia has been the hardest hit of the five countries with Ebola cases in West Africa, reporting at least 694 deaths among 1,378 cases. More than 3,000 cases have been reported across Liberia, Guinea, Sierra Leone, and Nigeria, and on Friday Senegal announced its first case.

A student from Guinea who had been missing showed up at a hospital in Dakar on Tuesday, seeking treatment but concealing that he had been in contact with other Ebola victims, Health Minister Awa Marie Coll Seck confirmed.

The student was tracked down in the Dakar hospital where he was confirmed with Ebola and immediately put into isolation, where he is reported to be in satisfactory condition.

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The point of it all is ‘‘they need to make more ZMapp.’’

"The WHO presented a road map for affected countries and the international community that included strategies designed to deal with more than 20,000 cases. The plans are likely to cost nearly half a billion dollars over six months. Tom Frieden, director of the US Centers for Disease Control and Prevention, warned the epidemic could get worse. He called for quicker international cooperation."

It is still picking up $peed and spreading:

"Amid poverty, US surgeons saving lives in Uganda" by Rodney Muhumuza | Associated Press   August 27, 2014

KAMPALA, Uganda — The American neurosurgeon leaned in to take a selfie with his patient, chuckling with excitement when she raised her hands. That was a good sign the day after Michael Haglund and his Duke University team opened the patient’s skull to remove a tumor.

The operation was one of many complex, life-saving surgeries the team performed for a week on Ugandan patients who otherwise had little hope of survival.

The operations, which would cost up to $20,000 here, are free while a group of American doctors take part in a ‘‘surgery camp’’ during which they also train local doctors. Scores of hopeful patients crowded the hallways of Mulago Hospital in the Ugandan capital of Kampala last week, forcing Haglund to perform triage in what he called doing ‘‘death rounds.’’

Although many were turned away, at least 22 people were operated on, including some who ‘‘were probably going to die,’’ Haglund said.

Public health services in Uganda have long been poor because of limited government funding, and many qualified but poorly paid health workers have sought opportunities in Europe and the United States. Although private hospitals are springing up, most people cannot afford their services in a country where many live on less than $1 a day.

The highly specialized field of neurosurgery is one of the hardest hit, with only six qualified neurosurgeons working across this East African country of 36 million.

Uganda’s main referral hospital, Mulago, presents a picture of decay and neglect. Just outside the operating theaters the floors are smeared with dried blood and the paint is peeling off the walls. The elevators fail at times, stranding nurses moving patients from operating rooms to the intensive care unit.

Vil Kengoma, the 21-year-old university student with whom Haglund took a photo, had a likely fatal brain tumor that left her in severe pain and paralyzed in her right hand. In the crowded ward where she rested after surgery to remove the tumor, she looked dazed but smiled at Haglund as he asked her to raise her hands.

‘‘She had been admitted for three weeks and she went straight from the intensive care unit to the surgery room,’’ said her sister Janet Karungi. ‘‘We are so grateful.’’

Haglund, a professor of surgery and of neurobiology at Duke, said he was shocked by what he saw when he first visited Mulago in 2007. There were 1,500 beds but just one ventilator for the operating theaters, he said.

‘‘The patients who were having brain surgery, they were getting into their brains with something like a hand drill,’’ he said. ‘‘Very crude . . . like 1930s US style.’’

Haglund said he decided to improve Mulago’s neurosurgery capacity, which has required fund-raising and spending his own money. His plan was to bring a surgical team of 20 to 40 people, including biomed engineers and anesthetists, who would join local surgeons to operate on dozens of patients each year.

Haglund’s team has come to Mulago nine times since then, bringing 45 tons of donated or used equipment worth $6.5 million. The machines have transformed what used to be a tea room inside Mulago’s main operating theater into a modern operating room — used primarily for neurosurgery — that is now named for Haglund.

Juliet Nalwanga, a Ugandan physician who is one of four doctors being trained in neurosurgery under Haglund’s mentorship, said the Duke team was doing an ‘‘amazing’’ job to improve local competence in neurosurgery while helping poor patients who would need up to $20,000 to get life-saving care.

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"Boko Haram claims it is Islamic caliphate" Associated Press   August 26, 2014

We already got one.

MAIDUGURI, Nigeria — Boko Haram, Nigeria’s Islamic extremist rebel group, said it controls the northeastern city of Gwoza and has added it to an Islamic state that it claims it has established in Nigeria.

Gwoza, in Borno state, is now part of its ‘‘Islamic caliphate’,’ asserted Boko Haram’s leader, Abubakar Shekau, in a video seen on Sunday.

‘‘We are grateful to God for the big victory he granted our members in Gwoza and made the town part of our Islamic caliphate,’’ Shekau said in the video.

But Nigeria’s army said on Twitter: ‘‘That claim is empty . . . the Nigerian state is still intact.’’

President Goodluck Jonathan declared a state of emergency in three northeastern states in May last year, saying the militants had taken over parts of Borno state, Boko Haram’s birthplace.

After the emergency was imposed, the military seemed to be gaining control of parts of the northeast.

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Nothing about the missing girls, huh? 

That's confirmation it was all a propaganda hoax.

"South Sudan rebels reject power sharing as UN crash probe begins" by William Davison | Bloomberg News   August 28, 2014

ADDIS ABABA, Ethiopia — South Sudan’s rebels have rejected a power-sharing deal proposed by East African leaders to end an eight-month conflict that has killed thousands of people in the world’s newest nation.

Last I knew they were starving. Then Ebola took over.

The proposal by the seven-nation Intergovernmental Authority on Development calls for President Salva Kiir to remain in office at least until elections, which should be held 60 days before the end of a 2½-year transitional period. Rebels led by former vice president Riek Machar would nominate a prime minister that Kiir would have to approve, according to the draft agreement.

‘‘It’s not the way to get peace in the country,’’ chief rebel negotiator Taban Deng Gai said Wednesday in a phone interview from the Ethiopian capital, Addis Ababa, where talks have been held. ‘‘We believe they’ve imposed Salva to be president for life. We’re not going to sign it.’’

Fighting erupted in South Sudan in December when Kiir accused Machar and other senior government officials of plotting a coup, a charge they deny. The conflict in the oil-producing nation has forced at least 1.5 million to flee their homes and left the country on the brink of famine, according to the United Nations. About 102,000 displaced people are sheltering at 10 UN bases, the world body said.

Conflict and oil seem to go hand in hand.

The UN is investigating the crash of one of its helicopters, which killed three Russians Tuesday. The rebels have denied government accusations that they shot it down.

It's Ukraine in reverse!

Kiir and East African leaders set a 45-day deadline for the formation of the transitional coalition government after a meeting on Monday. A previous deadline expired Aug. 10.

Several rounds of talks in have not curbed the violence, and without punishments for earlier failings, the new deal may fail to make a breakthrough, Solomon Dersso, an analyst at the Institute for Security Studies, said.

‘‘It’s not clear if that’s going to move anything forward at this stage,’’ he said.

Yes it is; it has been rejected.

The UN mission in South Sudan said its MI-8 helicopter crashed 6 miles south of Bentiu, the capital of Unity state, which has been wracked by fighting. The crash occurred three days after rebels detained six truce monitors.

Not getting as much press as the ISIS captives, are they?

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"South African court orders release of tapes" Associated Press   August 29, 2014

JOHANNESBURG — South Africa’s Supreme Court of Appeals on Thursday ordered the release of taped phone conversations about corruption charges against President Jacob Zuma, a move that could resurrect a case that has dogged the leader since before he took office.

Zuma had applied to prevent the tapes from being released while the opposition Democratic Alliance party sought access to them.

Zuma South Africa's Nixon?

Conversations on the recordings were cited as a reason to drop fraud and corruption charges against Zuma before he became president in 2009. The prosecuting authority at that time said the conversations showed there was a political conspiracy against Zuma, but the actual recordings were never made public.

Democratic Alliance leader Helen Zille applauded the decision by the court on Thursday, and said her party will analyze the tapes and determine if there were legal reasons to withdraw the charges against Zuma.

‘‘We are all equal before the law,’’ she said in court. ‘‘None of us is above the law. The court systems are being hijacked by politicians like Zuma and his network. . . . If anybody is suspected of a crime and if there is a case to be made, that person must have his day in court.”

The National Prosecuting Authority has five days to release the recordings and internal notes on discussions about why the charges were dropped. Zuma, who at the time was deputy president, was accused of accepting bribes to thwart an investigation into wrongdoing by a French arms company involved in a massive weapons deal in the late 1990s.

The National Prosecuting Authority’s acting director Mokotedi Mpshe in 2009 said he dropped fraud and corruption charges against Zuma because of prosecutorial misconduct. That decision came after Zuma’s legal team brought him taped phone conversations allegedly between prosecutors and a head of a now disbanded crime-fighting unit called the Scorpions about the charges and their timing.

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Time to get back into the lab:

"Harvard lab delves into Ebola outbreak" by Carolyn Y. Johnson | Globe Staff   August 28, 2014

Early this summer, tubes of inactivated Ebola virus from Sierra Leone began arriving at Harvard University.

Uh-oh.

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On Thursday in the journal Science, the team of scientists — including five African colleagues who died from Ebola before the research could appear — published the richest and most detailed portrait yet of the virus that is ravaging West Africa.

Those dead scientists sure have the "conspiratorial" websites ablaze.

The researchers’ analysis of Ebola samples taken from 78 patients in Sierra Leone reveals myriad small ways the pathogen has changed, accumulating 341 mutations that set it apart from past outbreaks.

Making me suspect creation in a defense weapons research lab.

The study also tracks how the virus spread into Sierra Leone in late May, when 14 women attended the funeral of a healer who had been working in Guinea. Researchers analyzed samples taken from a dozen of those women and found they carried back from the funeral two slightly different strains of the virus, the researchers concluded.

As the scientists made their discoveries, those findings were made available nearly in real time. Ebola samples would arrive in Cambridge, and within two weeks highly specialized equipment at the Broad Institute would generate genomic blueprints — a remarkable timeline, outside researchers said.

How interesting that Ebola came along when Broad was being closed for lack of funding!

A decade ago, “if we had outbreaks, whatever the outbreak was — dengue or chikungunya — two years after the epidemic you would say scientists working for the past two years have now shown this original strain originated in Indonesia.

“Whereas now, in real time, as the epidemic is going on, we’re able to do that pinpointing in the most elegant, specific, and sensitive manner,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “From a scientific standpoint, that is phenomenal.”

Because the findings are being generated and made public at such lightning speed, scientists have had little time to draw many conclusions. Keeping the genomes private so that Pardis Sabeti, a computational biologist at Harvard who supervised the work, and her lab could be the first to examine them fully — as is traditionally done in science — wasn’t an option. They began posting the genome sequences of the virus online in late June, hoping that crowd-sourcing the problems to laboratories around the world could more rapidly yield insights to help halt the spread of the outbreak, believed to be responsible for more than 1,500 deaths.

“There are two sides of it,” said Sabeti, who led the research with a scientist from Tulane University, Robert Garry, and the late Dr. Sheik Humarr Khan of Sierra Leone, a specialist in treating viral hemorrhagic fevers who was infected with the virus and died in July. “My lab has never been this sad and never been this motivated since I started it.”

Outside scientists said the genomes will provide clues that could help check whether tests used to detect the disease are keeping up with the mutating virus and allow scientists to trace the lineage of the virus, which they believe diverged from a Middle African strain of Ebola in 2004.

The data also show how rapidly the virus is mutating. Past outbreaks have burned out quickly and, therefore, have not given the virus as much of an opportunity to change in ways that make it more of a public health threat.

The durability of the ongoing outbreak means it is vital to keep an eye on how it is changing, Fauci said. So far, researchers have not seen evidence that the mutations are making the virus more dangerous.

But the researchers have already discovered that five standard tests used to diagnose Ebola in blood samples are not a perfect match for this strain. Now, they are testing whether those differences would have an effect on the test being able to certify someone has the virus.

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Thomas Geisbert, a professor of microbiology and immunology at the University of Texas Medical Branch in Galveston, said he didn’t immediately see any mutations that would affect the ability of ZMapp, an experimental therapy that has been used in several patients, to work.

The collaboration was made possible by relationships that developed for entirely different reasons....

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I guess the EMS workers will be earning those raises. 

So where did it come from again?

"Study dates origin of tuberculosis" by Carl Zimmer | New York Times   August 21, 2014

After a remarkable analysis of bacterial DNA from 1,000-year-old mummies, scientists have proposed a new hypothesis for how tuberculosis arose and spread around the world.

The disease originated less than 6,000 years ago in Africa, they say, and took a surprising route to reach the New World: It was carried across the Atlantic by seals.

The new study, published in the journal Nature, has already provoked strong reactions from other scientists.

“This is a landmark paper that challenges our previous ideas about the origins of tuberculosis,” said Terry Brown, a professor of biomolecular archeology at the University of Manchester.

But Helen Donoghue, an expert on ancient DNA at the University College London, rejected the idea that TB could have emerged so recently. “It just cannot be right,” she said.

Tuberculosis has long been one of the deadliest diseases. In 2012, 8.6 million people became ill with the infection, and it caused 1.3 million deaths, according to the World Health Organization. The invading bacterium, Mycobacterium tuberculosis, attacks the lungs, where it causes widespread scarring.

I read that and began thinking how all these crisis health threats pale in comparison to regular flu, cancers, and the rest. 

I'm not saying Ebola or these other things (West Nile, EEE) are not important, but the amount of attention and pre$$ seems out of whack when far greater dangers and killers are lurking.

To better understand the disease, a number of scientists have worked for decades to reconstruct its history.

In some people who get tuberculosis, the bacteria attack the skeleton, and archeologists have found signs of tuberculosis damage in bones dating back centuries.

But archaeological studies and genetic research have often reached different conclusions about the disease’s origins.

Some scientists have argued that tuberculosis spread from cows to humans when the animals were domesticated 10,000 years ago. Others have argued the disease is far older, having evolved about 70,000 years ago.

More when pigs fly stuff.

In the new paper, the team proposes that humans acquired tuberculosis in Africa around 5,000 years ago. The disease spread to people across the Old World along trade routes. Meanwhile, Africans also spread the disease to animals such as cows and goats.

Seals that hauled out onto African beaches to raise their pups became infected. The bacteria then spread through seals until it reached South America. Ancient hunters there became infected when they handled contaminated meat.

Until further research is done, Brown said he would keep an open mind.

“But I’d really like them to be correct,” he said, “because it is going to be fun rearranging all the deck chairs in my brain to accommodate this new idea.”

Yeah, that's a lot of fun while the damn ship is sinking.

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Maybe TB came here this way:

US fighting spread of giant snails

What do you mean "http://www.bostonglobe.com/Error/Generic?"

"The giant African snail damages buildings, destroys crops and can cause meningitis in humans. But some people still want to collect – and even eat – the slimy invaders.

The Agriculture Department is trying to stop them and since June has seized more than 1,200 live specimens of the large snails, also known as giant African land snails. All were traced back to one person in Georgia, who was selling them illegally.

The USDA discovered the snails through a tip from social media at the end of June. It seized more than 200 snails in Long Island, New York, from a person who identified the seller in Georgia.

The department interviewed the trader and seized almost 1,000 more snails, plus one each in Indiana, Pennsylvania and New York. The snails multiply quickly, producing 1,200 or more offspring a year, and they have no natural predators in the US.

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That reminds me, I've got to pick up the pace of posts next month.