SWINE HEALTHSWINE HEALTH

Dr. Randy HarpDr. Randy Harp

Herd Health ProblemsHerd Health Problems

►BiosecurityBiosecurity External biosecurityExternal biosecurity Internal biosecurityInternal biosecurity

Development of a Biosecurity Development of a Biosecurity PlanPlan

►AttitudeAttitude

““State of Mind”State of Mind”

Unforgiving attitude required because Unforgiving attitude required because disease is unforgivingdisease is unforgiving

Development of a Biosecurity Development of a Biosecurity Plan cont. Plan cont.

►Establish Herd Health GoalsEstablish Herd Health Goals

Healthy, productive system that can be Healthy, productive system that can be maintained maintained

Type of production systemType of production system Facility locationFacility location Health status of start-up herdHealth status of start-up herd CostCost

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►External BiosecurityExternal Biosecurity Keeping out new diseasesKeeping out new diseases

►Isolation/acclimatization (incoming stock)Isolation/acclimatization (incoming stock) Separate facility > 200 yards from herdSeparate facility > 200 yards from herd 45 – 60 days45 – 60 days First 30 days (isolation)First 30 days (isolation) Animals observed and blood testedAnimals observed and blood tested PRRS, PRV, brucellosis, TGEPRRS, PRV, brucellosis, TGE Parvo, Swine Influenza Parvo, Swine Influenza Last 30 days (acclimatization)Last 30 days (acclimatization) Vaccinate for Lepto, Erysiplas, ParvoVaccinate for Lepto, Erysiplas, Parvo

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►External BiosecurityExternal Biosecurity Keeping out new diseasesKeeping out new diseases

►Isolation/acclimatization (incoming stock) Isolation/acclimatization (incoming stock) cont.cont.

Animals exposed to cull sowsAnimals exposed to cull sows Allow opportunity to build immunityAllow opportunity to build immunity Donor herd health should be compared closely to Donor herd health should be compared closely to

that of the recipient herdthat of the recipient herd Administer vaccine as indicated by recipient herdAdminister vaccine as indicated by recipient herd Limit use of antibioticsLimit use of antibiotics

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►External BiosecurityExternal Biosecurity Keeping out new diseasesKeeping out new diseases

►SemenSemen Know isolation/acclimatization of boar stud Know isolation/acclimatization of boar stud Adequate disease monitoring program for boar studAdequate disease monitoring program for boar stud Procedures for boar stud should be as strict as those Procedures for boar stud should be as strict as those

for production unitsfor production units

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►External BiosecurityExternal Biosecurity Restrict access to visitors & create Restrict access to visitors & create

barriersbarriers►Perimeter fencePerimeter fence►Padlock all outside doorsPadlock all outside doors►Use signsUse signs►Require “clean out” time for visitorsRequire “clean out” time for visitors►Shower in / shower outShower in / shower out►Provide clothing and bootsProvide clothing and boots►Sanitize all incoming equipment Sanitize all incoming equipment ►Feed trucks limited Feed trucks limited

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►External BiosecurityExternal Biosecurity Develop and enforce strict chute rules Develop and enforce strict chute rules

►Trucks with manure should be excusedTrucks with manure should be excused►Load outs designed to prevent entryLoad outs designed to prevent entry►Establish sacred zones (off limit to trucks)Establish sacred zones (off limit to trucks)►Guillotine gateGuillotine gate►Boots should be provided for driversBoots should be provided for drivers►Clean, disinfect, and dry the landoutClean, disinfect, and dry the landout

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►External BiosecurityExternal Biosecurity Keep out other species of animals and Keep out other species of animals and

insectsinsects►Rodents, birds, dogs, cats, fliesRodents, birds, dogs, cats, flies►All can transmit diseasesAll can transmit diseases►Rats and flies can travel two milesRats and flies can travel two miles

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

► External BiosecurityExternal Biosecurity Locate new Locate new

production units production units away from other pigsaway from other pigs►Distance between Distance between

swine production swine production unitsunits

►Pig densityPig density►Probability of other Probability of other

pigs coming to areapigs coming to area

PathogenPathogenMinimum Minimum

distance to distance to prevent prevent

transmissiontransmission

Mycoplasma Mycoplasma pneumoniapneumonia

2 miles2 miles

TGETGE .5 miles.5 miles

Atrophic rhinitisAtrophic rhinitis .5 miles.5 miles

Strep suisStrep suis 2 miles2 miles

PseudorabiesPseudorabies 5 miles5 miles

PRRSPRRS ??????

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

► Internal BiosecurityInternal Biosecurity

Adopt optimum production system designAdopt optimum production system design►All-in / all-outAll-in / all-out►Multiple-site productionMultiple-site production►SEW (segregated early weaning)SEW (segregated early weaning)

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

► Internal Biosecurity Internal Biosecurity

Install barriersInstall barriers►Perimeter fencePerimeter fence►Bird wireBird wire►Tree lineTree line►Dead animal disposalDead animal disposal

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

► Internal BiosecurityInternal Biosecurity

SanitizationSanitization►Decontaminate rooms between groupsDecontaminate rooms between groups►Use high pressure spray, rinse all surfaces, Use high pressure spray, rinse all surfaces,

disinfect, dry, leave vacantdisinfect, dry, leave vacant

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►Vaccination ProgramVaccination Program

Leptospirosis, parvovirus, erysiplas Leptospirosis, parvovirus, erysiplas 2x/year2x/year

TGE, PRRS, Atrophic rhinitis, strep suis TGE, PRRS, Atrophic rhinitis, strep suis & ??& ??

Design with veterinarianDesign with veterinarian

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

► Internal and External Parasite ControlInternal and External Parasite Control

All incoming breeding stock should be All incoming breeding stock should be treatedtreated

Use fecal and skin monitoringUse fecal and skin monitoring

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►Slaughter ChecksSlaughter Checks Quarterly checksQuarterly checks

►Liver and lung lesionsLiver and lung lesions►Nasal turbinatesNasal turbinates

Only portion of herd need to be testedOnly portion of herd need to be tested►> 140 animals need 11 animals> 140 animals need 11 animals►> 1,000 animals need 29 animals > 1,000 animals need 29 animals

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►MonitoringMonitoring

Quarterly sampling for PRV and Quarterly sampling for PRV and brucellosis for seedstock herdsbrucellosis for seedstock herds

Serological testing for other diseased Serological testing for other diseased known to be in areaknown to be in area

Feed testing for mycotoxins Feed testing for mycotoxins

Development of a Biosecurity Development of a Biosecurity Plan cont.Plan cont.

►Feed additivesFeed additives

Growth promotant antibioticsGrowth promotant antibiotics

Alternative Disease Alternative Disease Control ProceduresControl Procedures

Alternative Disease Control Alternative Disease Control ProceduresProcedures

►Closed herdClosed herd Specific pathogen free (SPF)Specific pathogen free (SPF) Non SPFNon SPF

► Isolation of incoming breeding stockIsolation of incoming breeding stock

Alternative Disease Control Alternative Disease Control ProceduresProcedures

►Systems managementSystems management Multiple site production systemMultiple site production system All-in / all-outAll-in / all-out Segregated early weaning (SEW)Segregated early weaning (SEW)

►No controlNo control

Specific Pathogen Specific Pathogen Free (SPF)Free (SPF)

Specific Pathogen Free (SPF)Specific Pathogen Free (SPF)

►SPF is an attempt toSPF is an attempt to

Control diseasesControl diseases Improve managementImprove management

Specific Pathogen Free (SPF)Specific Pathogen Free (SPF)

► InitiallyInitially set up to control set up to control

Atrophic rhinitisAtrophic rhinitis Mycoplasma hyoneumoniaMycoplasma hyoneumonia

Specific Pathogen Free (SPF) Specific Pathogen Free (SPF) cont.cont.

►NowNow designed to eliminate & prevent designed to eliminate & prevent certain chronic growth retarding certain chronic growth retarding diseasesdiseases MangeMange LiceLice Swine dysenterySwine dysentery Atrophic rhinitisAtrophic rhinitis Mycoplasma pneumoniaMycoplasma pneumonia PseudorabiesPseudorabies BrucellosisBrucellosis

SPF schemeSPF scheme

►Sow – 112 to 114 days (C-section)Sow – 112 to 114 days (C-section)►Take pigs from sow, put in sterile Take pigs from sow, put in sterile

environmentenvironment►Rear in isolationRear in isolation►Restock other farmsRestock other farms

SPF pigs no immunological control, SPF pigs no immunological control, introduce to other pigsintroduce to other pigs

SPF classificationSPF classification

►Primary SPF Primary SPF pigs from C-sectionpigs from C-section

►Secondary SPFSecondary SPF Pigs from primary SPF orPigs from primary SPF or Pigs from other SPF farmsPigs from other SPF farms

Accreditation RequirementsAccreditation Requirements

►Proof of originProof of origin►Brucellosis validationBrucellosis validation►Pseudorabies validationPseudorabies validation►Herd inspection from veterinarianHerd inspection from veterinarian

Free of:Free of:►lice / mangelice / mange►Swine dysenterySwine dysentery

Accreditation Requirements Accreditation Requirements cont.cont.

►Quarterly health and disease reportsQuarterly health and disease reports►Submit quarterly litter registrationSubmit quarterly litter registration►Quarterly slaughter checks (10 head)Quarterly slaughter checks (10 head)

Atrophic rhinitisAtrophic rhinitis Mycoplasma hyopneumoniaMycoplasma hyopneumonia

Scour DiseasesScour Diseases

TGE (Transmissible TGE (Transmissible gastroenteritis)gastroenteritis)

►Cause - corona virusCause - corona virus

►Symptoms - major cause of death in Symptoms - major cause of death in young pigsyoung pigs Baby pigsBaby pigs

►Sudden vomitingSudden vomiting►Watery, yellowish diarrheaWatery, yellowish diarrhea►OdorOdor►90% death loss < 14 days old90% death loss < 14 days old

TGE (Transmissible TGE (Transmissible gastroenteritis) cont.gastroenteritis) cont.

► Symptoms cont.Symptoms cont. Older pigsOlder pigs

►Appetite lossAppetite loss►Diarrhea (mild)Diarrhea (mild)

► Control / PreventionControl / Prevention VaccineVaccine Good sanitationGood sanitation Bird and rodent controlBird and rodent control Management Management

E. Coli (colibacillosis)E. Coli (colibacillosis)

► Cause – bacteriaCause – bacteria

► SymptomsSymptoms Pale, yellow, watery diarrheaPale, yellow, watery diarrhea DehydrationDehydration Edema- produced by toxin of E. ColiEdema- produced by toxin of E. Coli Swollen eyelids, stomachSwollen eyelids, stomach Nervous signsNervous signs

►Staggering, head tilting, paddling, stumbling, dog sittingStaggering, head tilting, paddling, stumbling, dog sitting

E. Coli cont.E. Coli cont.

►Control / PreventionControl / Prevention SanitationSanitation ManagementManagement vaccinationvaccination

Swine DysenterySwine Dysentery

►Cause – bacteria (sepulina Cause – bacteria (sepulina hyodysenteriae)hyodysenteriae)

►SymptomsSymptoms Stool contains blood and mucusStool contains blood and mucus DehydrationDehydration Poor gain and efficiencyPoor gain and efficiency Some cases, deathSome cases, death

Swine Dysentery cont.Swine Dysentery cont.

►Control / PreventionControl / Prevention Management Management SanitationSanitation AntibioticsAntibiotics VaccineVaccine Control mice which harbor bacteria for 1 Control mice which harbor bacteria for 1

yearyear

RotavirusRotavirus

► Cause – virusCause – virus

► Symptoms – nursing pigs (about 3 weeks old)Symptoms – nursing pigs (about 3 weeks old) White, pasty scoursWhite, pasty scours Generally do not lose much weightGenerally do not lose much weight

► Control / PreventionControl / Prevention ManagementManagement SanitationSanitation Vaccine (antibiotics not effective)Vaccine (antibiotics not effective)

CoccidiosisCoccidiosis

► Cause – protozoa shed in fecesCause – protozoa shed in feces

► Symptoms – nursing pigs (7 - 10 days old)Symptoms – nursing pigs (7 - 10 days old) Diarrhea – yellow, light green / grayDiarrhea – yellow, light green / gray DehydrationDehydration

► Control / PreventionControl / Prevention Manure removal (it is shed in feces)Manure removal (it is shed in feces) Management (wash sows before entering Management (wash sows before entering

farrowing house)farrowing house) sanitationsanitation

SalmonellaSalmonella

► Cause – bacteriaCause – bacteria

► SymptomsSymptoms Acute septicemia (generalized infection of blood Acute septicemia (generalized infection of blood

and organs)and organs) DiarrheaDiarrhea AnorexiaAnorexia Fever, coughFever, cough Ears, nose, tail, feet,& abdomen become light Ears, nose, tail, feet,& abdomen become light

purplepurple Nervous disordersNervous disorders

►Posterior weakness, paddling, restlessnessPosterior weakness, paddling, restlessness

Salmonella cont.Salmonella cont.

►Control / PreventionControl / Prevention Antibacterials for treatmentAntibacterials for treatment Removal of affected pigsRemoval of affected pigs ManagementManagement SanitationSanitation VaccineVaccine Carrier pigs are indistinguishable from Carrier pigs are indistinguishable from

other pigsother pigs

Reproductive Reproductive DiseasesDiseases

BrucellosisBrucellosis

►Cause – brucella suis, bacteriaCause – brucella suis, bacteria

►Clinical SignsClinical Signs Fever – 5-7 daysFever – 5-7 days Abortion – any time during gestationAbortion – any time during gestation Weak pigs at birthWeak pigs at birth Genital tract infections & sterilityGenital tract infections & sterility

Brucellosis cont.Brucellosis cont.

►DiagnosisDiagnosis Blood agglutination testBlood agglutination test

►PreventionPrevention Herd testingHerd testing

►Initial testInitial test►Retain validationRetain validation

Retest all breeding stock annuallyRetest all breeding stock annually Test 20% of sows annually – cull sowsTest 20% of sows annually – cull sows

Brucellosis cont.Brucellosis cont.

►Prevention cont.Prevention cont. Introduce only negative animals into herdIntroduce only negative animals into herd Vaccination is unsuccessfulVaccination is unsuccessful

Under SPF, must be brucellosis freeUnder SPF, must be brucellosis free

LeptospirosisLeptospirosis

►Cause Cause Numerous organisms – bacteriaNumerous organisms – bacteria Transferable across speciesTransferable across species

►SymptomsSymptoms Fever, diarrheaFever, diarrhea Abortions – late gestationAbortions – late gestation Immature pigsImmature pigs

Leptospirosis cont.Leptospirosis cont.

►PreventionPrevention Vaccination once every 6 months is Vaccination once every 6 months is

effectiveeffective Use 5 way vaccine at weaningUse 5 way vaccine at weaning Blood test in not effectiveBlood test in not effective

SPF requires vaccinationSPF requires vaccination

ParvovirusParvovirus

Cause – virusCause – virus

SymptomsSymptoms►Embryonic & fetal deathsEmbryonic & fetal deaths►Mummified fetiMummified feti►Small littersSmall litters►Infrequent abortionInfrequent abortion►Delayed return to estrusDelayed return to estrus►AnestrusAnestrus

Parvovirus cont.Parvovirus cont.

►Prevention / ControlPrevention / Control VaccinationVaccination

Pseudorabies (Aujesky’s Pseudorabies (Aujesky’s disease)disease)

►Cause – herpes virusCause – herpes virus►SymptomsSymptoms

Young pigsYoung pigs►90% death loss in 3 -4 week olds90% death loss in 3 -4 week olds►40% death loss in 12 week olds40% death loss in 12 week olds

Older pigs > 50 lbs.Older pigs > 50 lbs.►Low death ratesLow death rates►Respiratory distressRespiratory distress

Pseudorabies (Aujesky’s Pseudorabies (Aujesky’s disease) cont.disease) cont.

► Symptoms cont.Symptoms cont. SowsSows

►Abortion – early gestationAbortion – early gestation►Retention of fetus – late gestationRetention of fetus – late gestation►Death of entire litter in 1 – 2 daysDeath of entire litter in 1 – 2 days

General signsGeneral signs►Fever Fever ►Convulsions & tremblingConvulsions & trembling►Ear infectionEar infection►Off feedOff feed►DiarrheaDiarrhea

Pseudorabies (Aujesky’s Pseudorabies (Aujesky’s disease) cont.disease) cont.

►DiagnosisDiagnosis Blood testBlood test

►VaccinationVaccination Modified live virusModified live virus Produces positive blood testProduces positive blood test

Pseudorabies (Aujesky’s Pseudorabies (Aujesky’s disease) cont.disease) cont.

►Control rulesControl rules Must have permit before entryMust have permit before entry Must have passed blood test in last 30 days Must have passed blood test in last 30 days

or be from PRV free herdor be from PRV free herd

►EradicationEradication Effort underway to eradicate PRV from the Effort underway to eradicate PRV from the

USUS

Porcine Reproductive & Porcine Reproductive & Respiratory Syndrome (PRRS)Respiratory Syndrome (PRRS)

►Cause – virusCause – virus

►Prevalence – 80 – 90% of swine in OK Prevalence – 80 – 90% of swine in OK test positive (LUCE)test positive (LUCE)

►Transmission – animal to animalTransmission – animal to animal

Porcine Reproductive & Porcine Reproductive & Respiratory Syndrome (PRRS) Respiratory Syndrome (PRRS)

cont.cont.►Clinical signsClinical signs

Breeding femalesBreeding females Fever – increased stillbornsFever – increased stillborns Depression – weak, liveborn pigsDepression – weak, liveborn pigs Abortions – preweaning mortalityAbortions – preweaning mortality

Porcine Reproductive & Porcine Reproductive & Respiratory Syndrome (PRRS) Respiratory Syndrome (PRRS)

cont.cont. Nursery pigsNursery pigs

►Rapid, labored breathingRapid, labored breathing►Poor performancePoor performance

Finishing pigsFinishing pigs►FeverFever►DepressionDepression►Off feedOff feed

Porcine Reproductive & Porcine Reproductive & Respiratory Syndrome (PRRS) Respiratory Syndrome (PRRS)

cont.cont.►ControlControl

VaccinationVaccination Depopulation / repopulationDepopulation / repopulation Multiple site productionMultiple site production

ErysipelasErysipelas

► Cause – bacteriaCause – bacteria

► SymptomsSymptoms FeverFever AbortionAbortion Diamond shaped lesions on skinDiamond shaped lesions on skin

► Control / PreventionControl / Prevention PenicillinPenicillin VaccinationVaccination

Streptococcus SuisStreptococcus Suis

► Cause – bacteriaCause – bacteria

► SymptomsSymptoms Weaned pigsWeaned pigs

►MeningitisMeningitis►AnorexiaAnorexia►Reddening of skinReddening of skin►Nervous disorders – loss of balance, paddling, shaking, Nervous disorders – loss of balance, paddling, shaking,

convulsionsconvulsions►Blindness & deafnessBlindness & deafness► If serious, can lead to “greasy pig”If serious, can lead to “greasy pig”

Streptococcus Suis cont.Streptococcus Suis cont.

► Symptoms cont.Symptoms cont. Breeding herdBreeding herd

►Decreased conception ratesDecreased conception rates►Decreased farrowing rateDecreased farrowing rate►Vaginal dischargeVaginal discharge

PneumoniaPneumonia

► Treatment / ControlTreatment / Control PenicillinPenicillin Management – reduce stress, ventilation, humidityManagement – reduce stress, ventilation, humidity VaccineVaccine

Respiratory DiseasesRespiratory Diseases

Mycoplasma HyopneumoniaMycoplasma Hyopneumonia

►Cause – mycoplasma hyopneumonia Cause – mycoplasma hyopneumonia bacteriabacteria Infectious respiratory disease of swineInfectious respiratory disease of swine

►Prevalence – 80 – 90% of US swine herdsPrevalence – 80 – 90% of US swine herds

►Transmission – animal to animal contactTransmission – animal to animal contact

Mycoplasma Hyopneumonia Mycoplasma Hyopneumonia cont.cont.

► Clinical signsClinical signs Sneezing Sneezing Dry coughDry cough ListlessnessListlessness Poor growth performancePoor growth performance

► Economic LossesEconomic Losses Death lossDeath loss Reduced feed efficiency 10 – 30%Reduced feed efficiency 10 – 30% gaingain

Mycoplasma Hyopneumonia Mycoplasma Hyopneumonia cont.cont.

►Treatment – antibiotics – LincomycinTreatment – antibiotics – Lincomycin

►Control – depopulationControl – depopulation Can live with it with good management, Can live with it with good management,

i.e. no stress, good nutritioni.e. no stress, good nutrition

Actinobacillus PleuropneumoniaActinobacillus Pleuropneumonia

►Cause – bacteriaCause – bacteria►Transmission – pig to pig contactTransmission – pig to pig contact►Clinical signsClinical signs

Sudden death 20 – 40%Sudden death 20 – 40% High feverHigh fever Loss of appetite (anorexia)Loss of appetite (anorexia) Lesions on lungs of growing swineLesions on lungs of growing swine

Actinobacillus Pleuropneumonia Actinobacillus Pleuropneumonia cont.cont.

►ControlControl VaccineVaccine Good herd healthGood herd health AntibioticsAntibiotics Management (all-in / all-out, age Management (all-in / all-out, age

segregation)segregation)

Atrophic RhinitisAtrophic Rhinitis

►Cause Cause Bordetella bacteriaBordetella bacteria Pasturella bacteriaPasturella bacteria

►TransmissionTransmission Pig to pig contactPig to pig contact

Atrophic Rhinitis cont.Atrophic Rhinitis cont.

►Clinical signsClinical signs►Affects nasal turbinate bone developmentAffects nasal turbinate bone development►Early sign in baby pigsEarly sign in baby pigs►SneezingSneezing►Distortion of noseDistortion of nose►PneumoniaPneumonia►Black areas around eyesBlack areas around eyes

Atrophic Rhinitis cont.Atrophic Rhinitis cont.

►ControlControl►VaccinationVaccination►Depopulation – only way to completely get rid Depopulation – only way to completely get rid

of of ►antibioticsantibiotics

Porcine Respiratory Disease Porcine Respiratory Disease Complex (PRDC)Complex (PRDC)

► Cause – both viral & bacterial pathogensCause – both viral & bacterial pathogens Primary bacterial pathogensPrimary bacterial pathogens

►Mycoplasma hyopneumoniaMycoplasma hyopneumonia►Actinobacillus pleuropneumoniaActinobacillus pleuropneumonia

Secondary bacterial pathogensSecondary bacterial pathogens►Pasturella multocidaPasturella multocida►Strep suisStrep suis►SalmonellaSalmonella

Usually a combination of PRRS, swine flu, PRV, & PRCVUsually a combination of PRRS, swine flu, PRV, & PRCV

Porcine Respiratory Disease Porcine Respiratory Disease Complex (PRDC) cont.Complex (PRDC) cont.

►SymptomsSymptoms Acute depressionAcute depression AnorexiaAnorexia FeverFever Nasal dischargeNasal discharge Coughing, labored breathingCoughing, labored breathing Increased mortality Increased mortality Reduced F/GReduced F/G Increased days to marketIncreased days to market

Porcine Respiratory Disease Porcine Respiratory Disease Complex (PRDC) cont.Complex (PRDC) cont.

►Prevention / ControlPrevention / Control Management (AI – AO, SEW, multi-site)Management (AI – AO, SEW, multi-site) Strict biosecurityStrict biosecurity Vaccination for 1Vaccination for 1°° and 2 and 2°° pathogens pathogens

AnthelminticsAnthelmintics

► IvomecIvomec►DectomaxDectomax►AtguardAtguard►Pyrantel TartratePyrantel Tartrate►Fenbendazole (Safeguard/Panacur)Fenbendazole (Safeguard/Panacur)►PiperazinePiperazine►LevisoleLevisole►BanmithBanmith