Rome: Where surfing and syndromic testing collide

The waves at Santa Marinella beach outside of Rome tumble rhythmically onto the sand–rising and falling like distant rolling hills. For an avid surfer, these placid waves would likely make for dull conditions. But for the kids attending the Surf4 Children camp, they are perfect. With excitement etched on their faces, they wade into the water with their boards. Some float, while others swim out to catch the waves. 

This unique surfing experience has become an important part of the children’s lives. After all, it was set up especially for them. Some of the children have autism, some have Down syndrome, others have diseases so rare, they haven’t even been named yet. They are children with special needs who every summer get to experience the joy of being in the water, just like other kids their age. 

“We wanted to create a cool atmosphere so they could share the same life experiences as other children,” says Danilo Buonsenso, pediatrician at the Gemelli University Hospital and and a founder of the camp. The children get the same adrenaline surge as any other child doing sports. “Surfing was something we could do in the water, which children love. It’s cheap and accessible to anyone according to their skills.” 

Buonsenso founded the camp with two other doctors over eight years ago. At the time, they were all medical residents and amateur surfers. When they first proposed the idea to the children’s families, they were perplexed, he says. At first, parents didn’t understand that such an activity could help the children’s socialization and integration into society. But now it’s an event that everyone looks forward to.

A holistic approach to health

Social justice and inclusivity have been important to Buonsenso since long before he launched the surf camp. While a student at the same university at which he now works, he saw the movie Motorcycle Diaries, a biopic about the life of Ernesto Che Guevara, who played an integral role in the 1953 Cuban Revolution. Guevara was a medical student before he set out on a motorcycle journey across South America. The adventure transformed him into the revolutionary figure he became after he witnessed the poverty, oppression and struggles of people across Latin America. The film inspired Buonsenso to pursue medicine and specialize in infectious diseases. 

Health, he says, is more than just about treating physical ailments. It includes the emotional benefits of feeling joy and being socially accepted and connecting with other people. Good health can also lift people out of poverty by enabling them to work, for example. 

Buonsenso witnessed this firsthand while he was a medical resident. He was searching for projects as part of his training in infectious diseases when he came upon the idea to help build a clinic in Bureh Town, a small surfing village in Sierra Leone. There were several medical residents involved. As they spent time in Bureh Town planning the clinic, he began to notice it had other positive effects: When he and his fellow residents spent their money in the village, it stimulated the local economy. And as the village residents invested their income in building out the surf infrastructure, more and more tourists arrived, generating even more income and lifting the spirits and general health of people in the community. 

In the end, the medical residents were able to help the village build a clinic to provide primary care medical services for conditions such as trauma, malaria and dehydration. They also raised enough money through donations to send a villager through nursing school, who now works at the clinic. 

The experience in Bureh Town sparked the idea to launch the surf camp in Rome, Buonsenso says. Eight years after starting the camp, Buonsenso has seen benefits in the children’s social development. One child now even surfs at well know surf locales around the world as a hobby. Many kids will soon make the transition into adulthood. “They face the challenge of inclusion within society. We are also building in new activities to help them integrate into the workforce,” Buonsenso adds.

Revolutionary inspiration

Balancing his interest in social issues with his work as a medical doctor isn’t easy–time is always short, he admits. But Buonsenso, who also holds a doctorate in public health, still manages to incorporate epidemiological research into his day. He spends his mornings making rounds seeing patients in the hospital ward, and his afternoons studying infectious diseases, such as COVID-19 and tuberculosis. 

Through his medical work and research, he has come to appreciate the importance of rapid, symptoms-based diagnostics. His patients with infectious diseases often present with multiple overlapping symptoms, making it difficult to diagnose them precisely. The symptoms of a pertussis infection, for example, can resemble an infection caused by one of several other possible respiratory pathogens. He relies on QIAstat-Dx mulitplex PCR syndromic testing to easily distinguish various causes of infections. 

Especially important is to test children with special needs, he says. They have “worse outcomes after viral infections and symptoms can be non-specific.” Access to rapid tests, such as QIAstat-Dx, enables earlier diagnoses and the ability to take appropriate preventive measures. It can also be helpful if these tests are extended to family members or caregivers with mild upper respiratory symptoms, he adds. 

Since the instrument tests for the presence of genetic material from multiple pathogens, he can better identify the culprit causing a patient’s symptoms. Identifying the pathogen quickly also enables him to prescribe the most appropriate treatment before symptoms become severe. 

And with the  QIAsphere app, Buonsenso can also check the results of his QIAstat-Dx tests remotely with his mobile device, even from the beach. “A doctor’s job doesn’t end when they leave the hospital,” he says. Being able to check results as soon as they are available means that patients get necessary treatment as quickly as possible.

Future research on viral infections

As a public health researcher, Buonsenso continues to study the effects of coronavirus infection in his patients, and he was one of the first to describe long COVID in children. Two years ago, he began to see kids, who months after mild coronavirus infections, were still having trouble breathing, were fatigued and suffering other symptoms. Testing found severely reduced blood flow in the lungs of some. Buonsenso hypothesized that tiny blood clots or damage to the lining of blood vessels were to blame. 

Since there are no widely accepted treatments for long COVID, Buonsenso tried anti-coagulant medication in some, with parental consent since his patients were minors and would not normally be candidates for such treatment. He has seen some children’s symptoms improve. But such anecdotal evidence isn’t sufficient to prove the medication helped. He has since applied for grant money to launch a long COVID clinical trial that would include a placebo group.

More broadly, the pandemic “has taught us that our knowledge of viral infections is not great,” Buonsenso says. That people can be asymptomatic and yet still transmit the coronavirus has led researchers to question long-held beliefs about how other viruses circulate. Take respiratory syncytial virus (RSV), a common respiratory infection among children, for example. RSV is a common and potentially severe virus and the dogma was that children mainly circulate the virus from other children that may have it as a mild upper respiratory infection, Buonsenso says. But now we are seeing that the elderly can also have severe RSV, he adds. “Everything is changing now. There are several new open questions, and of course, we need to do much more research on the long-term consequences of viral infections.”