Six people have been infected with the coronavirus in Lombardy, regional welfare councillor Giulio Gallera said Friday.
They are all about 40.
Gallera urged people in the towns of Codogno, Castiglione d'Adda and Casalpusterlengo to stay at home and avoid social contact.
He said some 250 people had been placed in isolation and would be tested for the deadly virus.
All six infected people are in serious condition, Lombardy Governor Attilio Fontana said.
Giuseppe Ippolito, scientific director of Italy's top infectious disease hospital, the Spallanzani in Rome, said "the cases reported in Lombardy are the first registered on Italian territory and take us into a new phase.
"For the first time we have moved from cases of importation to cases of local circulation of the virus".
The first case is a man, 38, who is believed to have got the virus after dining with a friend who had come back from China.
The other two initially infected people are the 38-year-old's wife, a pregnant teacher on maternity leave, and a third person who went to hospital suffering symptoms of pneumonia after doing sport with the 38-year-old.
The teacher had not been in contact with children.
The other three are clients of a bar Codogno, near Lodi, owned by the father of the man who did sport with the 38-year-old, sources said. The three customers never came into direct contact with the 38-year-old, according to the sources.
The town has closed schools, bars, eateries, discos, dancehalls, gambling arcades and sporting facilities as a precaution at least until Sunday.
The 38-year-old man was said to be in a serious condition, with respiratory insufficiency - but Gallera said his condition had "improved slightly" since Thursday night, when he was admitted.
The man went to the emergency room of the hospital on Thursday.
"Our son is in an extremely serious state. We're devastated," the 38-year-old's parents, who are in self isolation, told Fanpage.it.
"He's intubated, sleeping. It's pitiful.
"They told us not to go out and not to let anyone in.
"We don't have any symptoms, but we can't exactly say that we are well". Police have reconstructed his movements over the last four days, when he went to work, played football and took part in three dinners.
He also recently took part in two running races.
The man works for Unilever, based in Casalpusterlengo.
Casalpusterlengo closed schools on Friday.
A female colleague of his has been hospitalised with symptoms of the virus in Piacenza.
The police are also trying to reconstruct what his wife did, and whom she met, over the last few days.
She is believed to have had fewer contacts than him - and no contacts with children, despite her job.
The friend with whom he dined, meanwhile, has been taken to Milan's Sacco Hospital.
He is in isolation there. Gallera said he was "well".
He is thought to have come back to Italy on a China Airlines flight on January 21 and to have met the 38-year-old while he had flu symptoms, between February 1 and 8. He has, somewhat surprisingly, tested negative for the virus.
Virologist Giorgio Palù said that this was possible, for example if there was no clinically significant amount of virus left in his airways at the time of the test.
The wife with the coronavirus is also at the Sacco, where the entry of relatives into the ward has been strictly forbidden.
The first man's family members have been placed in isolation, sources said.
In the town where his parents live, Castiglione d'Adda, officials have stopped preparations for the carnival and closed schools until February 25. The council office and the library have been closed also.
Health Minister Roberto Speranza ordered obligatory quarantine for all the people who have been in contact with the carrier, before travelling to Lombardy.
The health ministry also ordered quarantine for all those who have returned from China in the last two weeks.
Premier Giuseppe Conte stressed that quarantine had been ordered as a necessary precaution and said "we are keeping the precautionary line high".
He warned against "social alarmism and panic".
Genoa Archbishop Cardinal Angelo Bagnasco, head of Europe's bishops, urged people "not to give in to fear, it doesn't help".
The local health agency in Piacenza, near where the friend who got back from China works at Fiorenzuola d'Arda, ordered checks on local employees of the same company.
The mayor of Fiorenzuola ordered tests on the employees at the friend's factory.
The factory, which makes equipment for making synthetic fibres and polymers for construction, has been closed Friday as a precaution. Authorities are weighing the use of military facilities for quarantine purposes.
In Lodi the first masks were being distributed amid coronavirus fears.
World Health Organization official Walter Ricciardi said the case of an infection in Italy had been forecast for months and now "sangfroid" was needed.
He said the new virus "is now present in Italy too and the new phase is marked by the presence of cases of secondary transmission of the infection", that is, picking up the virus from other people than those who have come from Wuhan and its surrounding province, Hubei. Doctors body FIMMG said GPs who examine patients for the coronavirus will have to wear masks, a special smock and glasses, provided by the ASL local health agency, to prevent them becoming contagious too.
The president of the infectious and tropical disease association, Marcello Tavio, told ANSA that "at the moment there is no reason to raise the level of alarm in Italy to the maximum". He said the top level was reserved for a situation in which "many indigenous cases are registered in various parts of Italy, that is you need many contagion points that emerge at the same time".
The Italian Soccer Federation said it was in constant touch with the health ministry and saw no reason to postpone professional football matches in Lombardy "for the moment".
The Lombardia amateur soccer league, however, said that it has postponed 40 matches Meanwhile the 55 Italians who returned from Wuhan on February 3 have now left quarantine at the Cecchignola military complex outside Rome.
There have been the first two deaths and 13 new infections, making a total of 634, on the Diamond Princess cruise ship off Japan.
Some 30 of 35 Italians on board the ship are returning to Rome on a military plane along with 27 Europeans.
The other five, the crew and the captain, have stayed on board.
Wall Street continued to tumble Friday, with investors seen as hesitant to hold onto shares amid fears the coronavirus outbreak in China could harm the global economy. More than 2,200 people have died from the disease in China, which has infected more than 75,000 people there and over 1,000 abroad.
An Italian man and a Chinese couple who contracted the coronavirus in China are being treated at the Spallanzani.
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