The Electric reports that three salmonella cases in Cascade County have been linked to the national outbreak strain.

Abigail Hill, county health officer, said the Montana Public Health and Human Services lab confirmed those links through genome testing and that the U.S. Centers for Disease Control and the U.S. Food and Drug Administration have been notified.

Hill said there are 12 states nationwide with confirmed linked salmonella cases.

She said the source hasn’t yet been determined, but likely some food with national distribution.

Hill said the state wasn’t sure when they’d get the next round of sequencing completed and have asked the Cascade City-County Health Department has asked the state what foods they want to test to determine if it matches the salmonella stain.

So far, there have been 11 confirmed salmonella cases in Cascade County, of those eight were students and one is an employee at Great Falls Public Schools at five different schools. Two other cases were unrelated to GFPS.

Hill said that it’s often hard to pinpoint the source with a single case, but with multiple cases, they can start to see trends and commonalities.

Hill told City Commissioners during their Nov. 19 meeting that while it was challenging for her staff to investigate the Cascade County cases, they’ve collected a lot of data on what those people ate and sourcing for GFPS foods to help the national investigation into the source of the outbreak.

Last week, CCHD said it was continuing to work with GFPS and have inspected the affected school kitchens and distribution kitchens and spoken with kitchen staff.

During the inspections, CCHD sanitarians didn’t observe any factors that would contribute to the spread of salmonella, according to the agencies update to The Electric on Nov. 15.

GFPS is continuing to provide CCHD with a list of students absent since Oct. 28 who have symptoms consistent with salmonella and whether those students ate hot lunch within the incubation period prior to the onset of symptoms.

CCHD is using those lists to expand their investigations to include probably or suspected cases of symptomatic students and staff who have not been tested and to identify any additional schools that may have suspected but unconfirmed cases, CCHD told The Electric on Friday.

GFPS also provided detailed menu lists of all foods served at the affected schools and manufacturers of those foods and CCHD is conducting follow-up investigations to determine which specific items were consumed by infected individuals during the salmonella incubation period, according to CCHD.

Parents may receive a text from CCHD with a link to a confidential and HIPPA-compliant electronic form where they can provide these details about the specific food items consumed by their children.

CCHD asks parents who received that text to review the menu lists with their children and submit the form as soon as able. If CCHD doesn’t receive a form, they’ll follow-up with those families by phone to obtain the information.

GFPS and CCHD notified the public on Nov. 12 of six confirmed salmonella cases among students at Sacajawea and Valley View elementary schools, one GFPS employee at a third school and one person in the community not tied to the district.

On Nov. 13, GFPS said that two more cases were identified, these at Meadowlark Great Falls.

GFPS said on Nov. 13 that parents in the schools with confirmed cases are being notified and that the district is continuing to work with CCHD to determine the source of the outbreak.

CCHD is also coordinating with the Montana Department of Health and Human Services, which in turn is coordinating with the U.S. Food and Drug Administration and the U.S. Centers for Disease Control.