What's the story?
On Tuesday, 11 new cases of babies being born with missing or deformed arms were identified through hospital records in the Ain area, near the Swiss border, between 2000 and 2014.
This was the latest development in a situation that started coming to public attention back in early October when several reports of an unusually high number of similar cases were reported in the Ain department of eastern France, Brittany on the West coast and Loire-Atlantique, south of Brittany.
Those reports revealed that seven babies had been born without arms or hands between 2009 and 2014 all within 17 km of the village of Druillat in the Ain department in eastern France (plot 1 on the map below).
Meanwhile in the town of Mouzeil in the western Loire-Atlantique department (plot 2 on the map below) a total of three children were born with the same birth defects between the years of 2007 and 2008.
And in 2015, Guidel (see below), a town in Brittany (plot 3 on the map below) was identified as a new area of concern after a doctor, and mother of one of the three babies born between 2011 and 2013 with the same medical problems, alerted the authorities.
After the new incidents came to light, Francois Bourdillon, head of the Public Health France agency, told RTL radio that the probe was “underway” and the results would be known “in about three months.”
“We will look at all suspect cases,” he said.
The national health agency had previously conducted an investigation the results of which were revealed at the beginning of October when it admitted for the first time that the situations in Loire-Atlantique and Brittany revealed an excessive number of these kinds of cases.
However at that point the agency said they did not believe the evidence suggested there has been an excessive level of cases in Ain and that there would be no further investigation.
Even without the 11 new cases, some scientists, who first picked up on the worrying trend in 2011, had said that the number of cases in Ain was 58 times the normal amount.
Do we know why it's happening?
In short, no. The phenomenon, which some have labelled a “health scandal”, remains unexplained.
However Remera, a public body which looks into cases of malformation, conducted an investigation into the situation in the Ain department, interviewing the mothers to see if there were any factors linking them and their pregnancies.
After speaking to the parents, doctors dismissed genetics, as well drugs and drink as possible causes for the deformations.
“We interviewed all the mothers with a very extensive questionnaire on their lifestyle. The only thing they have in common is that they all live in a very rural area,” Emmanuelle Amar, director of Remera in the south east of France, said.
While the cause of the defects are unknown, research has shown that exposure of the mother to certain chemicals or medication during the pregnancy can increase the risk.
Last week, Buzyn told French news channel LCI that environmental experts would join health experts in investigating the cases to try to shed light on the phenomenon.
Do we know how many children are born with these malformations in France?
There is currently no register of babies born with deformities such as those seen in these cases.
Instead there are just a few regional registers in the Rhône-Alpes, Brittany and the West indies that provide this kind of data.
Santé Publique France claims that an average of 150 babies are born each year around France with these kinds of birth defects however this figure is actually based on incomplete data which only takes into account 19 percent of France.
What is the most likely explanation?
The medical community in France is divided.
When it revealed the results of its first investigation in early October, France's public health authority, Santé Publique France said “the statistical analysis does not highlight an excess of cases compared to the national average”, referring directly to the cases in the Ain department.
“We have not identified a common exposure to the occurrence of these malformations,” said the director of the health body, François Bourdillon.
Guidel in Brittany. Photo: AFP
“For the Loire-Atlantique and Brittany, the investigation concludes that there has been an excess of cases however “no common exposure was identified for the clustered cases of these two regions,” said Anne Gallay another of the directors at Santé Publique France.
“We listened to their parents and their grandparents, visited the places where they live. No environmental factors – pesticides, for example – could be questioned.”
At that point, the organisation has described the situation as “tragic” for the people involved but for the moment suggests there is no explanation.
Previously the body had said that the cases were probably “down to chance”.
However on the other side of the argument, Remera has dismissed the likelihood of it being down to a chance occurrence as “more than infinitesimal”.
According to doctors at Remera, the most likely cause behind this extraordinarily unusual situation is the agricultural industry, meaning pesticides.
Not least because at the same time as these cases took place among the human population in the Ain department, several calves were born without a tail and missing ribs in Chalamont, another village in the department.
“It is believed that this revolves around agriculture,” said Amar.
“We have the elements, the data on these cases, but we need to bring the scientists together. For example, an ecotoxicologist (someone specialising on the effects of toxic chemicals on biological organisms) must work on it, and determine which is the most appropriate study,” she said.
“We are definitely facing an excess of cases. We have the scientific and moral obligation to go further,” director of Remera, Amar said.
What do the parents say?
Unsurprisingly, the parents of these children want answers.
Melinda Mostini (pictured with her son Leo above), one of the mothers concerned has questioned if “it could be environmental”.
In her interview with FranceInfo, she mentioned “fertilizers, pesticides” and said “there may have been something that happened at this time in the town”.
“I am outraged that no investigation has yet been launched,” Céline Figueiredo, mother of Sacha, one of the babies born in Ain, said.
“We have the means in France to investigate the causes of these malformations. They must try to give us answers rather than cover up the case.”
“We are impressed by Sacha. He never asks for help. But since he started at school, some of his friends have to ask him questions or make fun of him and he tells us he wants a hand.
“It is important for us to understand what may have happened during my pregnancy and to be able to answer him one day.”