The shigellosis outbreak that began in the Kansas City area in July continues to spread.

The Kansas City Star reports that the Jackson County Health Department has seen 62 cases so far this year, bringing the total in the metro area to more than 400.

Most of the cases have been within city limits and aren't counted among the Jackson County cases because the department covers parts of the county outside Kansas City and Independence.

More than half of the Jackson County cases occurred in October. The county typically sees fewer than 10 cases each year.

Shigellosis is an infectious intestinal disease caused by bacteria transmitted by people who have symptoms, including abdominal pain, fever, watery diarrhea, vomiting and fever.

Most of the region's cases have been associated with child care facilities and elementary schools.

SORAPONG CHAIPANYA, ThinkStock