When Samuel Bernard enrolled his 4-year-old son in preschool in a rural French town in the Ain region, he and his wife were prepared for their son to be teased.
Their child—born without his left hand and much of his forearm—had learned to hold a pencil and play like other children. But he would surely be made fun of, just by kids being kids.
On the first day of school, however, Bernard says he was shocked to discover that his son wasn’t so unique after all. He was one of four children in a class of 16 with similar birth defects affecting their hands and arms. One child was missing fingers, another the entire arm up to the elbow, a third was missing a hand.
Bernard and the other parents are part of a cluster of around two dozen families in two rural agricultural areas in France several hundred miles apart. These families have children born without hands or arms between 2011 and 2013.
France’s national health agency, Santé Publique, says they have now launched an investigation into the birth anomalies, hoping to find a common denominator that might lead to a cause.
So far, all they have found are more cases.
A simultaneous investigation has also been launched into reports that chickens and some calves were also born without limbs in the same rural areas during the time period, though most of the animals are dead by now, so that investigation has been more difficult to move forward.
Because there is no national registry of birth defects in France, cluster cases are often only discovered when the children start school, such as the case of Bernard’s son and his limbless peers. This is especially so in rural areas where communities are small and regional schools tend to draw student population from a large geographical area.
Authorities are looking at a variety of possibilities, including pesticides that may have been used or potential contamination to the water or food chain. “It could be an environmental issue,” France’s Health and Solidarity Minister Agnès Buzyn told French TV BFM. “It could be what they ate or what they drank. It could be something that they've breathed in. We don’t know, but the numbers are 60 percent higher in these areas than they should be.”
Authorities in France also don’t yet know the exact number of children that may be affected with similar birth defects, which will complicate any studies, says Betty Mekdeci, founder and executive director of Birth Defect Research for Children in the United States.
“In order to investigate a link between a birth defect and a potential cause, you need to nail down the numbers, the time frame, and the birth rate for the region where the birth defects were reported,” she told The Daily Beast. “Also, you need to know if the birth defects are the same. There are different expected rates for upper limb defects versus lower limb defects; for bilateral versus unilateral limb defects.”
Mekdeci says she got interested in the study of birth defects because her son has one. “I took the morning sickness drug Bendectin, and our son was born with a short right arm and mostly missing right hand,” she says.
Bendectin is made by the same company that made the infamous morning sickness pharmaceutical thalidomide, which caused thousands of babies to be born with severely malformed limbs in the 1950s and 60s. She spent a decade working to get Bendectin off the global market, often using experts who researched the effects of thalidomide.
Mekdeci says she believes the French case is likely tied to an agricultural product that was taken off the market in 2014, when the known cluster cases stopped.
Her group sponsors the National Birth Defect Registry aimed to collect data on birth defects and various exposures in each parent in the United States to try to find causes. When necessary, like in the case of the medicine that caused her own son’s birth defect, she then works to get the culpable products off the market.
Another hindrance to finding the cause of birth defect research is parental cooperation. In France, the group Remera is trying to establish a national registry like Mekdeci’s that would help better identify the clusters found near Brittany. They say that since news broke about the the cluster cases that affected Bernard’s son, they have had dozens of calls by concerned parents who either lived in or spent time in the same areas during pregnancy.
“It is often hard to get parents to cooperate in the U.S. also,” Mekdeci says. “They don’t get encouragement to look for causes.”
Europe's monitoring system for clusters of birth defects, known as EUROCAT (European Surveillance of Congenital Anomalies), has found 126 clusters of birth defects over the last decade, according to their website. Over half proved to be a result of faulty reporting or diagnostic anomalies, and just over a third were tied to environmental issues, mostly in the agriculture sector. The rest were deemed due to individual circumstances, either by one of the parents' exposure to toxins or due to what were determined to be genetic circumstances.
Initial results from the French investigation are expected to be published on January 31, with a final report in June. But the work so far has so far not yielded any concrete results, says Francois Bourdillon, head of the Public Health agency. She told French news outlets that despite questioning many of the parents of children with birth defects, there have been no incidences of known exposure to common substances. Environmentalists have been convinced that the cause has to be overuse of pesticides or other hidden chemicals, but Bourdillon says that if no cause for the coincidence is determined, it means the defects could simply be genetic.
Mekdeci doesn’t buy that possibility. “The most important concept is that every birth defect has a cause,” she says. “These things just don’t happen because of chance.”