Coronavirus emerged in Italy earlier than thought, study shows

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CNBC reported on Sun, Nov 15 20202:43 PM EST Updated Mon, Nov 16 20208:09 AM EST

• The new coronavirus was circulating in Italy since September 2019, a study by the National Cancer Institute (INT) of the Italian city of Milan shows.
  
• Italy’s first Covid-19 patient was detected on Feb. 21 in a little town near Milan, in the northern region of Lombardy.
  
• The World Health Organization has said the new coronavirus and Covid-19, the respiratory disease it causes, were unknown before the outbreak was first reported in Wuhan, in central China, in December.
  

The new coronavirus was circulating in Italy since September 2019, a study by the National Cancer Institute (INT) of the Italian city of Milan shows, signaling that Covid-19 might have spread beyond China earlier than previously thought.


The World Health Organization has said the new coronavirus and Covid-19, the respiratory disease it causes, were unknown before the outbreak was first reported in Wuhan, in central China, in December.

Italy’s first Covid-19 patient was detected on Feb. 21 in a little town near Milan, in the northern region of Lombardy.

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SARS-CoV-2 has been circulating in northern Italy since December 2019: Evidence from environmental monitoring


Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease COVID-19, a public health emergency worldwide, and Italy is among the most severely affected countries. The first autochthonous Italian case of COVID-19 was documented on February 21, 2020. We investigated the possibility that SARS-CoV-2 emerged in Italy earlier than that date, by analysing 40 composite influent wastewater samples collected - in the framework of other wastewater-based epidemiology projects - between October 2019 and February 2020 from five wastewater treatment plants (WWTPs) in three cities and regions in northern Italy (Milan/Lombardy, Turin/Piedmont and Bologna/Emilia Romagna). Twenty-four additional samples collected in the same WWTPs between September 2018 and June 2019 (i.e. long before the onset of the epidemic) were included as ‘blank’ samples. Viral concentration was performed according to the standard World Health Organization procedure for poliovirus sewage surveillance, with modifications. Molecular analysis was undertaken with both nested RT-PCR and real-rime RT-PCR assays. A total of 15 positive samples were confirmed by both methods. The earliest dates back to 18 December 2019 in Milan and Turin and 29 January 2020 in Bologna. Virus concentration in the samples ranged from below the limit of detection (LOD) to 5.6 × 104 genome copies (g.c.)/L, and most of the samples (23 out of 26) were below the limit of quantification of PCR.

Our results demonstrate that SARS-CoV-2 was already circulating in northern Italy at the end of 2019. Moreover, it was circulating in different geographic regions simultaneously, which changes our previous understanding of the geographical circulation of the virus in Italy. Our study highlights the importance of environmental surveillance as an early warning system, to monitor the levels of virus circulating in the population and identify outbreaks even before cases are notified to the healthcare system.

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