Update: Soon after the below article was published October 28, stating that a man had died in the Virginia hepatitis A outbreak, news outlets reported that a second person died. According to WFXRTV.com, that person is a woman in her 80s. No further details were given. Then on November 2, The Associated Press reported a third person died in the outbreak.

A man has died in the ongoing hepatitis A outbreak linked to three Famous Anthony’s restaurants in Roanoke County, Virginia, reports WSLS 10 News. So far, 49 people have contracted the hepatitis A virus, amid the outbreak, including 31 who were hospitalized.

James Hamlin, 75, died earlier this month of hepatitis A complications after 10 days in the hospital. He and his wife of 55 years had had breakfast at the restaurant before contracting hep A, his family told the news station. Before this illness, Hamlin, a military veteran who went to the gym regularly and ran marathons, was considered physically healthy.

His wife also became ill from the virus, which attacks the liver, but she is now recovering, her children said.

Health officials expect to see more cases linked to the outbreak because the incubation period for hepatitis A is 50 days. Cynthia B Morrow, MD, MPH, a health director with the Virginia Department of Health, told WSLS 10 in a separate article that current cases could be traced back to August.

Hepatitis is an inflammation of the liver. Hepatitis A virus (HAV) is most commonly spread through food or water contaminated with trace amounts of feces containing the virus. Hep A is also spread through close personal contact with a person who has the virus, among other ways.

Hepatitis A is an acute form of hepatitis, meaning it is not chronic or long term (unlike hepatitis B and C). Once you’ve had hep A, you can’t get reinfected. However, you can still contract hep B and C.

The best way to prevent hep A is to get vaccinated. The shot is safe and effective, and the Centers for Disease Control and Prevention recommends it to all 1-year-old children and populations at higher risk, such as people traveling to countries with higher hep A rates (including Central America and South America), men who have sex with men and people with chronic liver disease. For more details, see “How Can Hepatitis A Be Prevented?

Not everyone with hep A will show symptoms. But according to the Hep Basics, symptoms of hepatitis A (and acute hepatitis in general) include: 

  • Yellowing of the skin, whites of the eyes and under the fingernails (jaundice)
  • Feeling tired and rundown (fatigue)
  • Pain in the upper-right abdomen
  • Loss of appetite
  • Weight loss
  • Fever
  • Nausea
  • Diarrhea
  • Vomiting
  • Dark urine and/or pale stool
  • Joint pain.

Vaccines are also available for hepatitis B. Currently, there isn’t one for hep C, the other common type of hepatitis in the United States. To learn more about hepatitis and other liver diseases, see Hep’s Introduction to Hepatitis.

In related news, you can track hepatitis A outbreaks across the country with an interactive map and a roundup of related articles organized by state. To access the map and links, see “Hepatitis A in America.”

And for a roundup of hep A articles, click #Hepatitis A, where you’ll find headlines such as “Why Can’t Pharmacists in New York State Give Hepatitis Vaccinations? [VIDEO]” and “Five Goals of the New National Plan to End Viral Hepatitis.”