Coronavirus identified in Italy months before first confirmed case

The SARS-CoV-2 virus was likely circulating in northern Italy as early as November 2019, three months before the first case was formally identified in what would become the European region hardest hit by the first wave of the pandemic.

In a new report scheduled for publication next year, a team of researchers from the University of Milan and Memorial University of Newfoundland said a swab taken from a four-year-old boy who lived near Milan showed a 100 percent match for an early strain of the virus that broke out in Wuhan, China.

The boy showed his first symptoms, a cough and a runny nose, on Nov. 21, the scientists report in the February 2021 edition of Emerging Infectious Diseases, a publication of the Centers for Disease Control and Prevention. A week later, the boy was taken to the emergency room with respiratory problems and vomiting.

The next day, he began experiencing a rash, which doctors said resembled symptoms of measles. The swab showed no signs of measles — but later testing showed he had contracted the novel coronavirus.

The child had not traveled, suggesting the virus may already have been spreading around northern Italy.

The new research adds to evidence that the virus began spreading in Italy months before it was first identified in China. Previous research has identified remnants of the virus in untreated wastewater in the area around Milan beginning in mid-December.

The first positive case of the SARS-CoV-2 virus in Italy was identified in the town of Codogno, southeast of Milan, on February 21, 2020. Italy’s Lombardy region became the epicenter of the first wave of Europe’s outbreak in February and March, when health systems were so overwhelmed that some hospitals had to ration care.

“Long-term, unrecognized spread of SARS-CoV-2 in northern Italy would help explain, at least in part, the devastating impact and rapid course of the first wave of COVID-19 in Lombardy,” the researchers wrote.

Earlier studies of varying strains collected in the first months of the outbreak suggest the virus was introduced to Italy repeatedly, from both China and Germany.