Coronavirus: 'Patient Zero' Found in Italy

Italy was one of the first European countries to be hit by the COVID-19 epidemic in 2020, and it was hit hard.

Italian researchers are continuing to trace their country’s timeline of infection, identifying a 25-year-old woman from Milan as the new first-known case from November 10, 2019. Giovanni Fellegara, a pathologist at the Italian Diagnostic Center offered a comment:

We are absolutely all very proud of what we have done, it was a big team effort between professionals from three different institutions.

A chance occurence

Carried out by Milan University, the Italian Diagnostic Centre, and the European Institute of Oncology, the study called for re-testing the woman’s biopsy initially done for dermatitis. They say ‘fingerprints’ for Covid-19 were found in the skin tissue. The doctors had been reminded of her case when they started to see similar rashes in patients tested positive for COVID.

We initially participated in a study of Covid patients, finding virus proteins inside sweat glands. And then we looked for the same ‘fingerprints in skin biopsies made before the pandemic. And we found a patient in November 2019 with the same chemical characteristics.

More specifically, the Italian team employed a method called RNA FISH, which releases tracer molecules tuned to hook onto the coronavirus gene, and that are sensitive enough to track down even a single copy of the virus.

These findings help paint a picture of Italy’s initial phase of infection much before the first clinical case reported at the end of February 2020. Last month, scientists in Milan university retrospectively diagnosed a four-year-old boy. He was presented to the hospital with breathing difficulties and a rash at the end of November 2019. Doctors initially suspected measles. One year later, his sample was tested for COV-SARS-2 and was found to be positive.

Hunting down the virus

Another study of waste water also detected traces of the virus in December 2019 in the cities of Milan and Turin. A national surveillance system was subsequently set up to determine hot spots across the country. Researchers say that slowly, but surely, all the pieces of Italy’s pandemic puzzle will be uncovered.

We hope that our discovery creates a possibility of collaboration with other research groups, and therefore that this is [...] a starting point for other observations.

These are key discoveries as Italy enters its next stage of recovery. It is to hope more countries will be able to unravel the path of the 21th century's most infectious pandemic yet.