“The Italian outbreak has been traced to a 38-year-old man who sought treatment at a hospital in Codogno, near Milan, on Feb. 18, where he infected dozens of patients and medical staff. He had not been to China recently and how he became infected remains a mystery.”
https://www.bloomberg.com/news/articles/2020-02-25/safety-failures-bad-luck-fuel-italy-s-coronavirus-surge?srnd=premium