WFXR reports that the Roanoke City and Alleghany Health Districts announced Tuesday that the number of people infected with hepatitis A more than doubled over the last two weeks following an outbreak at three Famous Anthony’s locations, going from 14 to 35 cases.

Health officials first reported the outbreak on Sept. 24, saying that a person who worked at three different Famous Anthony’s locations tested positive for the highly contagious infection.

Then, on Sept. 28, the Roanoke City and Alleghany Health Districts’ director, Dr. Cynthia Morrow, reported that four more cases of the virus associated with the restaurant chain had been discovered, with at least three people hospitalized.

During her most recent update on Tuesday, Oct. 12, Dr. Morrow announced that approximately 35 hepatitis A cases have been confirmed in connection with this exposure, but that number is expected to rise as health officials investigate potential new cases that came in over the weekend.

Dr. Morrow says there have also been a handful secondary cases after people who were infected earlier on transmitted the virus to other people within their own households. However, there are no major clusters of such secondary infections.

In addition, there have been more than 20 hospitalizations reported as of Tuesday associated with this hepatitis A outbreak, according to Dr. Morrow.

Dr. Morrow says this is disappointing, but not surprising considering the long incubation period for hepatitis A — which can be up to 50 days — and the amount of time it can take people to seek medical care even after they start to show symptoms. The number of hepatitis A cases tied to this outbreak are expected to continue rising over the next few weeks.

The health districts say that anyone who visited any of the following Famous Anthony’s locations between Aug. 10 and Aug. 26 could have been exposed:

4913 Grandin Road
6499 Williamson Road
2221 Crystal Spring Avenue

According to health officials, if you have been exposed and are not vaccinated against hepatitis A, you should monitor yourself for the symptoms listed below, which can develop 15 to 50 days after exposure:

Jaundice (yellowing of the skin or the eyes)
Loss of appetite
Abdominal pain
Dark urine
Light-colored stools

Besides getting the hepatitis A vaccine, Dr. Morrow says practicing good hand hygiene and cooking hygiene are ways to help ward off the virus.