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Italy’s new ‘patient 1’ identified: Milan woman had coronavirus in November 2019

A woman in Milan was positive for the new coronavirus in November 2019, researchers have found, making her the earliest known patient in Italy to date.

Italy's new 'patient 1' identified: Milan woman had coronavirus in November 2019
A new study indicates the coronavirus was circulating in Italy in early November 2019. Photo: Miguel Medina/AFP

Traces of the virus were detected in skin cells from a 25-year-old woman who had a biopsy for an unusual skin condition on November 10th 2019, according to Raffaele Gianotti, a researcher in dermatology at the University of Milan, who believes she could be “the dermatological Italian patient zero”. 

At the time the woman reported having a mild sore throat, and months later tested positive for Covid-19 antibodies in her blood.

Previously the first confirmed Covid-19 patient in Italy was a child in Milan, who was swabbed after developing a measles-like rash in early December 2019 – two months before it became clear that the virus was circulating in the nearby town of Codogno, where 'native' cases were first detected in mid-February.

READ ALSO: Coronavirus was already in Italy by December, waste water study shows

Gianotti and a team from the European Institute of Oncology (IEO) and the Italian Diagnostic Centre analysed skin samples taken in the autumn of 2019 to investigate whether any of the patients who reported unexplained skin conditions might in fact have been showing symptoms of Covid-19.

Their study, to be published in the British Journal of Dermatology, found molecular traces of the SARS-CoV-2 virus in the biopsy taken from areas of reddened skin on the Milan woman's arms, which fitted a pattern seen in other Covid-19 patients. The virus can cause skin disorders including rashes and discolouration of fingers or toes, though they are less common than the 'classic' symptoms (fever, tiredness and a dry cough). 

The woman, who had no other symptoms apart from a sore throat and was not tested for coronavirus at the time, reported that her rash disappeared by April 2020 and she tested positive for antibodies in June.

“All these facts lead us to believe that our patient could represent the oldest case in literature of
detection of the virus on tissue sample,” the researchers write.

They do not believe that she was the first person in Italy to contract the new coronavirus, however: “Probably, continuing to search, we would also find [the virus] in samples from October 2019”, Gianotti told Ansa news agency.

A separate study found traces of SARS-CoV-2 in samples of waste water in Milan and Turin from December 2019, though not from October or November.

Meanwhile more than 100 people who enrolled in a lung cancer screening trial between September 2019 and March 2020 were discovered to have antibodies in their blood, indicating that they had already been exposed to the virus without noticing symptoms. A handful of people had developed antibodies as early as the first week of September 2019, recent research found.

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COVID-19 VACCINES

Italy’s deputy health minister under fire after casting doubt on Covid vaccines

Opposition leaders called for health undersecretary Marcello Gemmato to resign on Tuesday after the official said he was not "for or against" vaccines.

Italy's deputy health minister under fire after casting doubt on Covid vaccines

Gemmato, a pharmacist and member of Prime Minister Giorgia Meloni’s far-right Brothers of Italy party, made the remark during an appearance on the political talkshow ReStart on Rai 2 on Monday evening.

READ ALSO: Covid vaccines halved Italy’s death toll, study finds

In a widely-shared clip, the official criticises the previous government’s approach to the Covid pandemic, claiming that for a large part of the crisis Italy had the highest death rate and third highest ‘lethality’ rate (the proportion of Covid patients who died of the disease).

When journalist Aldo Cazzullo interjects to ask whether the toll would have been higher without vaccines, Gemmato responds: “that’s what you say,” and claimed: “We do not have the reverse burden of proof.”

The undersecretary goes on to say that he won’t “fall into the trap of taking a side for or against vaccines”.

After Gemmato’s comments, the president of Italy’s National Federation of Medical Guilds, Filippo Anelli, stressed that official figures showed the Italian vaccination campaign had already prevented some 150,000 deaths, slashing the country’s potential death toll by almost half.

Vaccines also prevented eight million cases of Covid-19, over 500,000 hospitalisations, and more than 55,000 admissions to intensive care, according to a report from Italy’s national health institute (ISS) in April 2021.

Gemmato’s comments provoked calls for him to step down, including from the head of the centre-left Democratic Party, Enrico Letta.

“A health undersecretary who doesn’t take his distance from no-vaxxers is certainly in the wrong job” wrote the leader of the centrist party Action, Carlo Calenda, on Twitter.

Infectious disease expert Matteo Bassetti of Genoa’s San Martino clinic also expressed shock.

“How is it possible to say that there is no scientific proof that vaccines have helped save the lives of millions of people? You just have to read the scientific literature,” Bassetti tweeted. 

In response to the backlash, Gemmato on Tuesday put out a statement saying he believes “vaccines are precious weapons against Covid” and claiming that his words were taken out of context and misused against him.

The Brothers of Italy party was harshly critical of the previous government’s approach to handling the Covid crisis, accusing the former government of using the pandemic as an excuse to “limit freedom” through its use of the ‘green pass’, a proof of vaccination required to access public spaces. 

But since coming into power, Meloni appears to have significantly softened her stance.

Her appointee for health minister, Orazio Schillaci, is a medical doctor who formed part of the team advising the Draghi administration on its handling of the pandemic.

Schillaci, a former dean of the Faculty of Medicine and Surgery at Rome’s Tor Vergata University, has described the former government’s green pass scheme as an “indispensable tool for guaranteeing safety in university classrooms”.

Speaking at a session of the G20 on Tuesday, Meloni referenced the role of vaccines in bringing an end to the Covid pandemic.

“Thanks to the extraordinary work of health personnel, vaccines, prevention, and the accountability of citizens, life has gradually returned to normal,’ the prime minister said in a speech.

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