key: cord-1007715-0jtb46tu authors: Wang, Wei; Zhou, Dajin; Jia, Xu; Feng, Youjun title: Influenza‐like illnesses caused by a cluster of imported Italian COVID‐19 date: 2020-04-13 journal: J Med Virol DOI: 10.1002/jmv.25869 sha: 9524b8af768e3b9e195c8d933c8c9d2bc2717d0c doc_id: 1007715 cord_uid: 0jtb46tu The ongoing pandemic of 2019 corona‐virus disease (COVID‐19) is caused by an emerging family of SARS‐CoV‐2, threatening human health worldwide. Here we report a cluster of Italian COVID‐19 imported to Lishui City, China. Of all the eight patients, 7 consistently display cough, a representative sign of influenza‐like illness (ILI), and the remaining one is a cryptic case. This further our understanding a full spectrum of COVID‐19 repertoire. This article is protected by copyright. All rights reserved. Letter to the editor The 2019 novel corona-virus (initially termed as 2019-nCoV, and thereafter formally renamed as SARS-CoV-2) originating from Wuhan City, China, is an etiological agent of ongoing outbreaks of corona-virus disease (COVID-19) 1, 2, 3 . Phylogenetic analysis suggested that SARS-CoV-2 is possible progenitor of SARS-CoV with bat origin 4, 5 . As of April 8, 2020, the pandemic of COVID-19 has swept almost 184 countries (and/or regions), comprising 1,485,981 cases of confirmed SARS-CoV-2 infection (https://www.gisaid.org/epiflu-applications/global-cases-covid-19). Not surprisingly, China has become one of severely affected epidemic area of COVID-19, which is fulfilled with 82,870 infection cases (3,339 deaths). Of note, Zhejiang province is one of best controlled place within China, in that only one death of 1,267 confirmed COVID-19 cases is recorded. Italy is a seriously affected country outside China, whose number of confirmed patients (139,442 cases) is next to those of Spain (148,220 cases) and United States (432,438 cases). As for those individuals travelling between Zhejiang Province and Italy, the potential carriers of COVID-19 are not clinically addressed. Here, we close the missing gap on this issue. We are the first to report a cluster of imported COVID-19 cases from Italy. In total, we have observed 8 confirmed SARS-CoV-2 cases. Except that the patient 8 give no syndrome, all the other seven individuals display the mild symptom of an influenza-like illness (ILI), like cough ( Fig. 1) . More 1) . Along with the presence of a single ground-glass opacity in the right bottom lobe (Fig. S1B) , the positive diagnosis of P2 for SARS-CoV-2 by Qingtian County Center for Disease Control and Prevention on Mar 2, 2020, prompted the arrival of being transferred to the hospital of centralized isolation in Lishui City, on Mar 3 (Fig. 1) . Not surprisingly, her younger brother This article is protected by copyright. All rights reserved. of P1 (P3: male, 28-year old) presented the clinical onset of cough, and slight inflammation of left lung (Fig. S1C) , which is fully consistent with the detection of SARS-CoV-2 in his oropharyngeal swabs (Fig. 1) . Unlike her husband (P5: male, 32-year old), the patient 6 (P6: female, 31-year old) displayed the onset of cough one week earlier (Fig. 1) . Both them were verified by CT and nucleic acid detection to be positive for COVID-19 (Figs 1 and S1E-F) . Evidently, the above five cases defined two familial clusters of person-to-person transmission of COVID-19. Different from that the confirmed SARS-CoV-2 case of P4 (male, 35-year old) is clinically characterized with sneezing (Fig. S1D) , P7 (male, 40-year old) displayed dizziness on his clinical onset (Fig. S1G) . It was unusual for Patient 8 (P8: male, 33-year old) that he had no detective onset (Fig. S1H) The authors declare that they have no competing interests. This work was financially supported by National Natural Science Foundation of China (31830001, YF). This was a retrospective study of COVID-19 conducted in Lishui People's Of note, all the eight patients (P1 to P8), whose hometowns refer to Qingtian County, worked in the same restaurant in Bergamo City, Italy. P2 is the husband of P1, and P3 was the younger brother of P1. P6 was the wife of P5. A Novel Coronavirus from Patients with Pneumonia in China Clinical Characteristics of Coronavirus Disease 2019 in China Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention 2019-nCoV: A possible progenitor for SARS-CoV with bat origin? Genomic characterization and infectivity of a novel SARS-like coronavirus in Chinese bats Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study On Feb 27, all the patients purchased charter service from Bergamo City Shanghai Pudong International Airport. Among the 8 patients One day later, all the remaining seven individuals with close contact with Patient 1 in Italy, the epidemic area of COVID-19, was recognized as positive for SARS-CoV-2 Slight cough (but not fever), a symptom of influenza-like illness (ILI), is the representative characteristics of this cluster of imported cases with COVID-19 Designations: CT, Computed tomography; the plus "+", positive for COVID-19