Italy reported a total of 229 novel coronavirus cases on Monday, leaping ahead of Japan (156 cases) on the list of worst-hit countries. Seven people have died from the respiratory disease COVID-19 in Italy, and 27 more are in intensive care.

Italy’s biggest cluster of cases is in the Lombardy region, which has 172 cases, the country’s Health Ministry said Monday afternoon. The Veneto region, which includes Venice, has 33 cases, and Emilia-Romagna has 18.Italian health officials have ordered a quarantine for tens of thousands of residents in Lombardy. But as NPR’s Sylvia Poggioli reports from Rome, Italy’s experts have not been able to piece together how the coronavirus got a foothold there.
“Angelo Borrelli, head of the national Civil Protection [Department], expressed frustration, telling reporters, ‘Health officials have not yet been able to pinpoint patient zero,’ ” Poggioli reports for NPR’s Newscast unit.

As they watched the number of COVID-19 cases grow to hundreds, officials in Lombardy, banned large public gatherings and shut down schools, universities, museums, movie theaters and other gatherings for at least one week.