P-94 COVID-19 outbreak related to the first workplace cluster in Noor Aliza Lodz 1 , Chong Zhuo Lin 1 , Wan Shakira Rodzlan Hasani 1 , Noor Ani Ahmad 1 , Fazila Haryati Ahmad1 ,Halizah Mat Rifin1 , Shubash Shander Ganapathy 1 , Nur Liana Ab Majid 1 , Nik Adilah1 Shahein 1 , Muhd Hafizuddin Taufik Ramli1 1 , Zazarida Zakiman 2 , Salina Md Taib 2 , Lee Soo Cheng 2 , Rama Krishna Supramaniam 2 , Muhammad Haikal Ghazali1 3, Mohamed Paid Yusof 2 NMRR-20-720-54598. 1 Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, , 40170, , Malaysia 2 Petaling Health Office, Ministry of Health Malaysia, 47301, , Selangor 3 Selangor State Health Department, Ministry of Health, 40100, , Selangor

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INTRODUCTION The first Malaysian case of covid-19 was the ninth case reported at the beginning of February 2020 1 . This 42-year-old businessman had a travel history to Singapore from 16th to 23rd January 2020 for an International Conference. He was also the index case of the first local transmission cluster in Malaysia2 . Malaysia was free of COVID-19 cases for 11 days before the second wave of the disease arrived late February 2020 3 . Most of the early cases in the second wave were initially imported and sporadic4 . However, a case notified on 28th February 2020 to Petaling District Health Office (DHO) in the Selangor State, Malaysia, was later found to link to a cluster from a business corporate in Malaysia 5 . During this time, there was no specific guidelines from the Ministry of Health Malaysia for the corporate companies on handling the outbreak. Here, we reported the detectionand management of this COVID-19 first business cluster in Malaysia by Petaling DHO.

OBJECTIVE This study aimed to report the detection and management of COVID-19 from the first and one of the largest clusters linked to a business corporate in Malaysia from Petaling District, Selangor Epidemiology Curve for Cluster A

MATERIALS AND METHODS

• This is a descriptive study analysis that was conducted from the surveillance data of Petaling district health office (DHO) notified on 28th February 2020 until 22nd of March 2020. • All cases and contacts were identified through surveillance, epidemiological investigation, and laboratory investigation. • The network graph was done using the software R and the epidemiology curve was done using Microsoft Excel.

RESULTS & DISCUSSION • From 28th February to 22nd March 2020, a total of 1536 people were traced by 3/1/2020 3/3/2020 3/5/2020 3/7/2020 3/9/2020 Petaling DHO linked to the cluster. 2/18/2020 2/20/20202/22/20202/24/2020 2/26/20202/28/2020 3/11/20203/13/2020 3/15/20203/17/20203/19/2020 • The total number of positive COVID-19 cases from this cluster was 126 out of 1536 which come to an attack rate of 8.2% Figure 1: Epidemiology Curve for Cluster A in Petaling District • 63 of them, which was 50% of the total number in the cluster, lived in Petaling District. Other positive cases were transferred to the respective according to their house addresses. 58 23 120 57 56 Table 1: Socio-demographic and symptoms characteristics for Cluster A in Petaling District 22 32 37 36 47 52 38 65 33 60 70 14 21 63 62 6 9 53 59 30 29 10 11 18 48 99 20 13 24 61 69 46 45 76 55 17 15 19

12 25 35 34 27 28 40 39 90 43 26 74 31 66 41 50 16 42 49 94

Figure 2: Generations of transmission based on the epi-link

CONCLUSION Cluster of COVID-19 in this workplace setting was curbed quickly, within three weeks, due to the efficient control efforts by the Petaling DHO with mutual co-operation with the employer and other related DHO. They did all the necessary measures to prevent the outbreak from getting worse and bigger.

References 1. Malaysia M of H. Official Portal MInistry of Health, Malaysia. Press Statement 9 February 2020. http://ww- w.moh.gov.my/index.php/database_stores/store_view_page/21/1311. Published 2020. Accessed April 28, 2020. 2. Pung R, Chiew CJ, Young BE, et al. Investigation of three clusters of COVID-19 in Singapore: implications for surveillance and response measures. Lancet. 2020;395(10229):1039-1046. doi:10.1016/S0140-6736(20)30528-6 3. CDC. Guidelines for Investigating Clusters of Health Events. Centers for Disease Control and Prevention. https://w- ww.cdc.gov/mmwr/preview/mmwrhtml/00001797.htm. Published 2001. Accessed April 28, 2020. 4. Malaysia M of H. Official Portal MInistry of Health, Malaysia. Press Statement. 27 February 2020. http://ww- w.moh.gov.my/index.php/database_stores/store_view_page/21/1332. Published 2020. Accessed April 29, 2020. 5. Malaysia M of H. Official Portal MInistry of Health, Malaysia. Press Statement 1 March 2020. http://www.moh.gov- .my/index.php/database_stores/store_view_page/21/1335. Published 2020. Accessed April 29, 2020.