Deep learning-based image classification of turtles imported into Korea.

Although turtles play a key role in maintaining healthy and balanced environments, these are endangered due to global trade to meet the high demand for food, medicine, and pets in Asia. In addition, imported non-native turtles have been controlled as alien invasive species in various countries, including Korea. Therefore, a rapid and accurate classification of imported turtles is needed to conserve and detect those in native ecosystems. In this study, eight Single Shot MultiBox Detector (SSD) models using different backbone networks were used to classify 36 imported turtles in Korea. The images of these species were collected from Google and were identified using morphological features. Then, these were divided into 70% for training, 15% for validation, and 15% for test sets. In addition, data augmentation was applied to the training set to prevent overfitting. Among the eight models, the Resnet18 model showed the highest mean Average Precision (mAP) at 88.1% and the fastest inference time at 0.024 s. The average correct classification rate of 36 turtles in this model was 82.8%. The results of this study could help in management of the turtle trade, specifically in improving detection of alien invasive species in the wild.

Association between discrimination in the workplace and insomnia symptoms.

Background: In Korea, little research has focused on the relationship between discrimination in the workplace and sleep health. Thus, this study aims to investigate the association between such discriminatory experiences and insomnia, a common sleep disorder, using Korean employees' data. Methods: This study used data from the 6th Korea Working Conditions Survey. Discrimination experiences due to age, ethnic background, nationality, race, sex, religion, disability, sexual orientation, educational level, hometown, and employment status were investigated. The Minimal Insomnia Symptom Scale estimated insomnia symptoms. The association between discrimination experience and insomnia symptoms were analyzed using survey-weighted logistic regression analysis. Results: Based on experiences of discrimination over the past 12 months, insomnia symptoms were associated with discrimination experience due to religion (odds ratio [OR]: 3.70; 95% confidential interval [CI]: 1.58-8.69), sex (OR: 2.51; 95% CI: 1.87-3.37), age (OR: 2.30; 95% CI: 1.88-2.81), hometown (OR: 2.07; 95% CI: 1.44-2.97), employment status (OR: 1.69; 95% CI: 1.37-2.10), and educational level (OR: 1.67; 95% CI: 1.31-2.14). Furthermore, the prevalence of insomnia symptoms increased with the number of discrimination experiences. Conclusions: In this study, discrimination experiences due to religion, sex, age, hometown, employment status, and educational level were significantly associated with insomnia symptoms. Furthermore, as the number of discrimination experiences increased, so did the prevalence of insomnia. Preventing workplace discrimination may improve workers' sleep health.

Analysis of the complete mitogenome of Daphnia galeata from the Han River, South Korea: structure comparison and control region evolution.

Daphnia galeata is an important plankton in aquatic ecosystems. As a widely distributed species, D. galeata has been found throughout the Holarctic region. Understanding the genetic diversity and evolution of D. galeata requires the accumulation of genetic information from different locations. Even though the mitochondrial genome (mitogenome) sequence of D. galeata has already been reported, little is known about the evolution of its mitochondrial control region. In this study, D. galeata samples were collected from the Han River on the Korean Peninsula and its partial nd2 gene was sequenced for haplotype network analysis. This analysis showed that four clades of D. galeata were present in the Holarctic region. Moreover, the D. galeata examined in this study belonged to clade D and was specific to South Korea. The mitogenome of D. galeata from the Han River showed similar gene content and structure compared to sequences reported from Japan. Furthermore, the structure of control region of the Han River was similar to those of Japanese clones and differed substantially from European clone. Finally, a phylogenetic analysis based on the amino acid sequences of 13 protein-coding genes (PCGs) indicated that D. galeata from the Han River formed a cluster with clones collected from Lakes Kasumigaura, Shirakaba, and Kizaki in Japan. The differences in control region structure and stem and loop structure reflect the different evolutionary directions of the mitogenomes from Asian and European clones. These findings improve our understanding of the mitogenome structure and genetic diversity of D. galeata.

Sialocele and Its Association with Hypercortisolism and Long-Term Glucocorticoid Treatment in Dogs: Retrospective Case-Control Study.

Dogs with sialocele often have concurrent hypercortisolism or are receiving long-term glucocorticoid treatment. However, their association has not been investigated. This retrospective matched case-control study investigated the association between hypercortisolism, long-term glucocorticoid treatment, and sialocele in dogs. We retrospectively reviewed the records from 1 January 2018 to 31 December 2022. Records of 19 dogs diagnosed with sialocele were investigated for hypercortisolism and long-term glucocorticoid treatment. Two age- and breed-matched controls for each sialocele dog (38 dogs) were investigated for the same concurrent diseases. Logistic regression analysis was used. The odds of sialocele in dogs with hypercortisolism were 15.56 times those of dogs without hypercortisolism (p = 0.02; 95% CI: 1.54-156.79). The odds of sialocele in dogs with long-term glucocorticoid treatment (median, 8 months; range, 5-13) were 7.78 times those of dogs without long-term glucocorticoid treatment (p = 0.03; 95% CI: 1.23-49.40). No associations were found between age, sex, body weight, and the presence of sialocele. The results indicate that sialocele was significantly associated with hypercortisolism and long-term glucocorticoid treatment in dogs. Therefore, dogs with hypercortisolism or receiving long-term glucocorticoid therapy should be screened for possible sialocele. Additionally, dogs with sialocele should be identified for concurrent hypercortisolism and prolonged glucocorticoid exposure.

Image Classification of Amazon Parrots by Deep Learning: A Potentially Useful Tool for Wildlife Conservation.

Parrots play a crucial role in the ecosystem by performing various roles, such as consuming the reproductive structures of plants and dispersing plant seeds. However, most are threatened because of habitat loss and commercial trade. Amazon parrots are one of the most traded and illegally traded parrots. Therefore, monitoring their wild populations and global trade is crucial for their conservation. However, monitoring wild populations is becoming more challenging because the manual analysis of large-scale datasets of images obtained from camera trap methods is labor-intensive and time consuming. Monitoring the wildlife trade is difficult because of the large quantities of wildlife trade. Amazon parrots can be difficult to identify because of their morphological similarity. Object detection models have been widely used for automatic and accurate species classification. In this study, to classify 26 Amazon parrot species, 8 Single Shot MultiBox Detector models were assessed. Among the eight models, the DenseNet121 model showed the highest mean average precision at 88.9%. This model classified the 26 Amazon parrot species at 90.7% on average. Continuous improvement of deep learning models classifying Amazon parrots may support monitoring wild populations and the global trade of these species.

A case report of toxic hepatitis caused by chloroform in automotive parts manufacturer coating process.

Background: Several cases of chloroform-induced hepatotoxicity have been reported worldwide, but only 2 cases have been reported in Korea. We encountered a case of toxic hepatitis due to chloroform exposure in February 2022 and report the diagnosis process and clinical findings. Case presentation: A 38-year-old employee in charge of the coating after washing (degreasing) at an automotive parts manufacturer complained of jaundice and was diagnosed with acute toxic hepatitis. After the initial diagnosis, he continued to work, his symptoms worsened, and he was hospitalized for 8 days. Liver ultrasonography (elastography) revealed acute hepatitis. The washing agent contained chloroform, which was not listed on the materials safety data sheet, and the concentrations of chloroform in the workplace were up to 4.7 times the time-weighted average. Conclusions: This patient showed typical toxic hepatitis with chloroform; further follow-up studies are required. Both employers and workers should be aware of information on toxic substances and take precautions to avoid exposure.

Comparative analysis of complete mitochondrial genomes of three Trichoglossus species (Psittaciformes: Psittacidae).

BACKGROUND: The genus Trichoglossus belongs to the family Psittacidae and includes fourteen species distributed worldwide. According to the International Union for Conservation of Nature and Natural Resources (IUCN) Red List of Threatened Species, most Trichoglossus species have shown a decreasing population trend recently. In particular, Trichoglossus forsteni is listed as "Endangered" in the IUCN Red List of Threatened Species. Moreover, Trichoglossus haematodus and Trichoglossus moluccanus are one of the most traded and illegally traded parrots. However, only a few genetic studies have been conducted regarding the conservation of this genus. METHODS AND RESULTS: In the present study, complete mitochondrial genomes of three species (T. forsteni, T. haematodus, and T. moluccanus) were sequenced and compared with Trichoglossus rubritorquis, species whose mitochondrial genome is already reported. Results indicate that the complete mitochondrial genomes of the three species were similar in length (17,906 bp for T. haematodus to 17,909 bp for T. forsteni). Furthermore, the organization and order of these three mitochondrial genomes were identical, including thirteen protein-coding genes (PCGs), two ribosomal RNA genes, 22 transfer RNA genes, and two control regions (CRs) categorized into three domains containing nine conserved motifs. In addition, the genus Trichoglossus formed a well-supported monophyletic lineage. CONCLUSIONS: The results of this study may be useful for future genetic studies toward the conservation of the genus Trichoglossus.

Influence of coexposure to long working hours and ergonomic risk factors on musculoskeletal symptoms: an interaction analysis.

OBJECTIVES: This study explores the interaction between ergonomic risk factors and long working hours on musculoskeletal symptoms by additive and multiplicative scales. DESIGN: We used the data of the fifth Korean Working Condition Survey (KWCS). The KWCS is a cross-sectional study. SETTING: To represent the entire Korean working population, the probability proportion stratified cluster sampling method was used. The face-to-face interview was carried out with a structured questionnaire. MAIN OUTCOMES AND MEASURES: To assess the combined effect of ergonomic risk factors and long working hours on musculoskeletal symptoms, the relative excess risk due to interaction (RERI) and the ratio of ORs were calculated using multiple survey-weighted logistic analysis and postestimation commands. RESULTS: The OR for musculoskeletal symptoms was 1.75 (95% CI 1.28 to 1.39) for exposure to long working hours, 3.49 (95% CI 3.06 to 3.99) for exposure to ergonomic risk factors and 5.07 (95% CI 4.33 to 5.93) for coexposure to long working hours and ergonomic risk factors. The RERI was 0.82 (95% CI 0.11 to 1.53) and the ratio of ORs was 0.83 (95% CI 0.50 to 1.14) CONCLUSION: Our findings suggest that coexposure to both ergonomic risk factors and long working hours has a supra-additive interaction effect on musculoskeletal symptoms. Regulations on working hours and workplace interventions might reduce the musculoskeletal diseases of workers.

Seasonal Diversity of Microeukaryotes in the Han River, Korea Through 18S rRNA Gene Metabarcoding.

Freshwater ecosystems contain a large diversity of microeukaryotes that play important roles in maintaining their structure. Microeukaryote communities vary in composition and abundance on the basis of temporal and environmental variables and may serve as useful bioindicators of environmental changes. In the present study, 18S rRNA metabarcoding was employed to investigate the seasonal diversity of microeukaryote communities during four seasons in the Han River, Korea. In total, 882 unique operational taxonomic units (OTUs) were detected, including various diatoms, metazoans (e.g., arthropods and rotifers), chlorophytes, and fungi. Although alpha diversity revealed insignificant differences based on seasons, beta diversity exhibited a prominent variation in the community composition as per seasons. The analysis revealed that the diversity of microeukaryotes was primarily driven by seasonal changes in the prevailing conditions of environmental water temperature and dissolved oxygen. Moreover, potential indicator OTUs belonging to diatoms and chlorophytes were associated with seasonal and environmental factors. This analysis was a preliminary study that established a continuous monitoring system using metabarcoding. This approach could be an effective tool to manage the Han River along with other freshwater ecosystems in Korea.

Association between insomnia and absenteeism or presenteeism among Korean employees.

Background: In Korea, few studies clarify insomnia and its association and absenteeism or presenteeism. Therefore, this study aims to examine the association between insomnia and absenteeism/presenteeism using the sixth Korean Working Conditions Survey. Methods: Insomnia was evaluated by the Minimal Insomnia Symptoms Scale (MISS). Absenteeism and presenteeism were assessed by asking if the employee had experienced absence or working despite being ill for the prior 12 months at the point of the survey. Multiple logistic analyses were conducted to explore insomnia and its association with absenteeism and presenteeism. Results: The odds ratios of insomnia for absenteeism and presenteeism were 3.48 (95% confidence interval [CI]: 2.76-4.39) and 3.68 (95% CI: 3.18-4.26) in the fully adjusted model. As the MISS scores increased, absenteeism and presenteeism showed the increasing trend that odd ratios increased accordingly from the first to the fourth quartile. Conclusions: This study observed that insomnia was related to both absenteeism and presenteeism among Korean employees.

Comparative Analysis of Complete Mitogenomes of Two Oxyurichthys Gobies and Their Phylogenetic Implication.

Oxyurichthys is a genus of goby that is widespread in the tropical Indo-West Pacific region. Oxyurichthys species are usually found in estuarine and coastal marine habitats. In Southeast Asia, they are commercial fishes and often collected by trawling to serve the market's demand. The mitogenome serves as a good marker for investigating the systematics and evolution of fishes, but the mitogenome of Oxyurichthys species remains unknown. In this study, mitogenomes of two Oxyurichthys gobies, O. ophthalmonema and O. microlepis, were characterized and compared. The sizes of the mitogenomes were 16,504 bp and 16,506 bp for O. ophthalmonema and O. microlepis, respectively. Mitogenomes of these two species were similar in gene content and structure. Both included 37 genes and a control region. The two Oxyurichthys mitogenomes shared similar gene features and base composition with other recorded gobies. Typical conserved blocks (CSB-1, CSB-2, CSB-3 and CSB-D) were found in the control region of both species. Phylogenetic analyses based on concatenation of 13 protein-coding genes and 2 rRNAs revealed that the two Oxyurichthys species clustered together and were sister to species of the genera Sicydium, Sicyopterus and Stiphodon. The findings of the present study support previous evolutionary studies of gobies using other molecular markers.

Medical X-band linear accelerator for high-precision radiotherapy.

PURPOSE: Recently, high-precision radiotherapy systems have been developed by integrating computerized tomography or magnetic resonance imaging to enhance the precision of radiotherapy. For integration with additional imaging systems in a limited space, miniaturization and weight reduction of the linear accelerator (linac) system have become important. The aim of this work is to develop a compact medical linac based on 9.3 GHz X-band RF technology instead of the S-band RF technology typically used in the radiotherapy field. METHODS: The accelerating tube was designed by 3D finite-difference time-domain and particle-in-cell simulations because the frequency variation resulting from the structural parameters and processing errors is relatively sensitive to the operating performance of the X-band linac. Through the 3D simulation of the electric field distribution and beam dynamics process, we designed an accelerating tube to efficiently accelerate the electron beam and used a magnetron as the RF source to miniaturize the entire linac. In addition, a side-coupled structure was adopted to design a compact linac to reduce the RF power loss. To verify the performance of the linac, we developed a beam diagnostic system to analyze the electron beam characteristics and a quality assurance (QA) experimental environment including 3D lateral water phantoms to analyze the primary performance parameters (energy, dose rate, flatness, symmetry, and penumbra) The QA process was based on the standard protocols AAPM TG-51, 106, 142 and IAEA TRS-398. RESULTS: The X-band linac has high shunt impedance and electric field strength. Therefore, even though the length of the accelerating tube is 37 cm, the linac could accelerate an electron beam to more than 6 MeV and produce a beam current of more than 90 mA. The transmission ratio is measured to be approximately 30% ~ 40% when the electron gun operates in the constant emission region. The percent depth dose ratio at the measured depths of 10 and 20 cm was approximately 0.572, so we verified that the photon beam energy was matched to approximately 6 MV. The maximum dose rate was measured as 820 cGy/min when the source-to-skin distance was 80 cm. The symmetry was smaller than the QA standard and the flatness had a higher than standard value due to the flattening filter-free beam characteristics. In the case of the penumbra, it was not sufficiently steep compared to commercial equipment, but it could be compensated by improving additional devices such as multileaf collimator and jaw. CONCLUSIONS: A 9.3 GHz X-band medical linac was developed for high-precision radiotherapy. Since a more precise design and machining process are required for X-band RF technology, this linac was developed by performing a 3D simulation and ultraprecision machining. The X-band linac has a short length and a compact volume, but it can generate a validated therapeutic beam. Therefore, it has more flexibility to be coupled with imaging systems such as CT or MRI and can reduce the bore size of the gantry. In addition, the weight reduction can improve the mechanical stiffness of the unit and reduce the mechanical load.

Development of polymorphic microsatellite markers for the Trichoglossus haematodus and cross-species amplification in Trichoglossus moluccanus.

BACKGROUD: Trichoglossus haematodus is the most popular parrots globally and one of the most bred species in Korea's zoos. However, despite its popularity, there are limited studies on the population genetics of this species. METHODS AND RESULTS: In this study, 10 polymorphic microsatellite markers were developed for T. haematodus. The number of alleles ranged from 6 to 9 (mean 7.9). Null alleles were present in two loci (TH-07 and TH-08). The observed heterozygosity ranged from 0.4444 to 1.0000 (mean 0.7000). One locus (TH-08) indicated a significant deviation from the Hardy-Weinberg equilibrium after Bonferroni correction (p < 0.005). The mean inbreeding coefficient (FIS) of the 10 loci was positive, suggesting that there is inbreeding in the population. Since the polymorphism information content (PIC) values were more than 0.7 in all loci, all markers developed in this study were classified as informative. The parentage exclusion probabilities considering all loci were higher than 0.99 in all three cases (P1, P2, and P3). The cross-species amplification of the 10 markers was tested in T. moluccanus, a close relative species of T. haematodus. These markers were also informative for T. moluccanus with PIC values higher than 0.7 in all loci. Additionally, the parentage exclusion probabilities (P1, P2 and P3) for T. moluccanus were above 0.99. However, due to the small number of T. haematodus and T. moluccanus investigated in this study, the 10 microsatellite markers should be analyzed with more individuals of these two species in future studies. CONCLUSIONS: The markers developed in this study might be helpful for investigations of genetic diversity and parentage analysis of T. haematodus and T. moluccanus.

An Investigation of the Variations in Complete Mitochondrial Genomes of Lingula anatina in the Western Pacific Region.

Lingula anatina is a brachiopod widely distributed in the western Pacific region. Even though L. anatina has been targeted for a number of biological studies, there is still limited information on intraspecific genetic variations of L. anatina. In this study, L. anatina specimens were collected from Korea and Vietnam, and complete mitochondrial genome (mitogenome) sequences were analyzed and compared with previous records. The total mitogenomes of L. anatina were 24,875 bp and 25,305 bp in size for Korean and Vietnamese specimens, respectively. Those mitogenomes are extraordinarily longer than the typical mitogenome size for an animal but shorter than the previous record from Yanagawa (Japan) for this species. The gene orders and the sizes of the protein-coding genes are also different from those for the Japanese specimen. Furthermore, the nonsynonymous (Ka) and synonymous (Ks) substitution rates in protein-coding genes (PCGs) were calculated to test the idea of evolutionary rate differences in mitochondrial genomes. The analyses showed relatively low Ka and Ks for the complete mitogenomes from Buan (Korea), Doson (Vietnam) and Yanagawa (Japan). The Ka/Ks ratio was less than 1 in comparisons of three localities, indicating the existence of purifying selection in this species. The phylogenetic analyses showed that L. anatina diverged among localities in the western Pacific region.

Development of a compact X-band linear accelerator system mounted on an O-arm rotating gantry for radiation therapy.

A compact X-band linear accelerator (LINAC) system equipped with a small and lightweight magnetron was constructed to develop a high-precision image-guided radiotherapy system. The developed LINAC system was installed in an O-ring gantry where cone-beam computed tomography (CBCT) was embedded. When the O-arm gantry is rotated, an x-ray beam is stably generated, which resulted from the stable transmission of radio frequency power into the X-band LINAC system. Quality assurance (QA) tests, including mechanical and dosimetry checks, were carried out to ensure safety and operation performance according to the American Association of Physicists in Medicine's TG-51, 142, an international standard protocol established by accredited institutions. In addition, delivery QA of the radiotherapy planning system was conducted to verify intensity-modulated radiotherapy techniques. Therefore, it was demonstrated that the developed X-band LINAC system mounted on the O-arm gantry proved to be valid and reliable for potential use in CBCT image-guided radiation therapy.

Characterization and Comparative Analysis of Complete Mitogenomes of Three Cacatua Parrots (Psittaciformes: Cacatuidae).

Cacatua alba, Cacatua galerita, and Cacatua goffiniana are parrots of the family Cacatuidae. Wild populations of these species are declining with C. alba listed by the International Union for the Conservation of Nature and Natural Resources (IUCN) as Endangered. In this study, complete mitogenomes were sequenced for a comparative analysis among the Cacatua species, and a detailed analysis of the control region. Mitogenome lengths of C. alba,C. galerita, and C. goffiniana were 18,894, 18,900, and 19,084 bp, respectively. They included 13 protein coding genes, two ribosomal RNA genes, 24 transfer RNA genes, three degenerated genes, and two control regions. Ten conserved motifs were found in three domains within each of the two control regions. For an evolution of duplicated control regions of Cacatua, domain I and the 3' end of domain III experienced an independent evolution, while domain II and most of the regions of domain III was subjected to a concerted evolution. Based on a phylogenetic analysis of 37 mitochondrial genes, the genus Cacatua formed a well-supported, monophyletic, crown group within the Cacatuidae. Molecular dating results showed that Cacatua diverged from other genera of Cacatuinae in the middle of Miocene.

Application of Testing-Tracing-Treatment Strategy in Response to the COVID-19 Outbreak in Seoul, Korea.

BACKGROUND: Following the coronavirus disease 2019 (COVID-19) outbreak in Wuhan, China, a total of 637 patients had been diagnosed with the disease in Seoul as of May 2, 2020. Our study aimed to describe the impact of the 3T strategies (preemptive testing, prompt tracing and proper treatment) on the epidemiological characteristics of COVID-19 in Seoul. METHODS: The descriptive and explanatory analysis was carried out on critical indicators such as epidemiological characteristics and key duration of patient status change from January 24 to May 2 in Seoul before and after preemptive testing for patients under investigation associated with COVID-19 clusters. RESULTS: Preemptive testing increased the positive test rate (3.9% to 4.2%), an asymptomatic case at diagnosis (16.9% to 30.6%), and reduced the time from symptom onset to quarantine (4.0 to 3.0 days). Prompt tracing decreased unknown sources of infection (6.9% to 2.8%), the mean number of contacts (32.2 to 23.6), and the time-varying reproduction number R(t) (1.3 to 0.6). With proper treatment, only 2 cases of mortality occurred, resulting in a fatality rate of just 0.3%. CONCLUSION: In the first wave of the COVID-19 pandemic lasting 100 days, the effect of the 3T strategies flattened the curve and decreased the time during which infected individuals were contagious, thereby lowering the R(t) below 1 in Seoul.

Coronavirus Disease Exposure and Spread from Nightclubs, South Korea.

At least 246 cases of coronavirus disease (COVID-19) have been linked to nightclubs in Seoul, South Korea. During the April 30-May 5 holiday, young adults from across the country who visited nightclubs in Seoul contracted COVID-19 and spread it nationally. Nightclubs were temporarily closed to limit COVID-19 spread.

Association between employment status and sickness presenteeism among Korean employees: a cross-sectional study.

BACKGROUND: Sickness presenteeism (SP) indicates "going to work while being ill." The importance of SP has only recently been investigated, and the association between SP and employment status has been inconsistent across studies. Therefore, we conducted this study to explore the association between SP and employment status by using presenteeism propensity (PP), which can reflect the individual decision-making process. METHODS: The study population included employees participating in the 5th Korean Working Condition Survey. We analyzed data of only employees with at least one health event, which was calculated as the sum of SP and sickness absenteeism days. Employment status was grouped into 3 categories: stable employment, unstable employment (contract period ≥ 1 year), and unstable employment (contract period < 1 year). Survey-weighted logistic regression analysis was conducted to assess the association between employment status and PP (dichotomized as "≤ 0.5" and "> 0.5"). RESULTS: Unstable employees (contract period ≥ 1 year) had higher odds of PP than stable employees (odds ratio [OR]: 1.23, 95% confidence interval [CI]: 1.03-1.47), whereas unstable employees (contract period < 1 year) had lower odds of PP than stable employees (OR: 0.82, 95% CI: 0.71-0.96). CONCLUSIONS: Employment status was associated with SP. Given the negative health impact of SP, social efforts, such as paid sick leave, are required to reduce SP and enhance the health status of unstable workers.

Coronavirus Disease Outbreak in Call Center, South Korea.

We describe the epidemiology of a coronavirus disease (COVID-19) outbreak in a call center in South Korea. We obtained information on demographic characteristics by using standardized epidemiologic investigation forms. We performed descriptive analyses and reported the results as frequencies and proportions for categoric variables. Of 1,143 persons who were tested for COVID-19, a total of 97 (8.5%, 95% CI 7.0%-10.3%) had confirmed cases. Of these, 94 were working in an 11th-floor call center with 216 employees, translating to an attack rate of 43.5% (95% CI 36.9%-50.4%). The household secondary attack rate among symptomatic case-patients was 16.2% (95% CI 11.6%- 22.0%). Of the 97 persons with confirmed COVID-19, only 4 (1.9%) remained asymptomatic within 14 days of quarantine, and none of their household contacts acquired secondary infections. Extensive contact tracing, testing all contacts, and early quarantine blocked further transmission and might be effective for containing rapid outbreaks in crowded work settings.