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A fourth person has died in a hepatitis A outbreak traced to Famous Anthony's restaurants in Roanoke Valley in Virginia.

Larry Vest died on Christmas after fighting the liver disease for months. His wife Diane, who was also infected, died in the fall of 2021.

More than 50 people were infected with the hepatitis A virus in relation to an infected employee who worked at three Famous Anthony's locations at Grandin Road Extension, Williamson Road and Crystal Spring Avenue, according to public health officials. Infected people may not show symptoms for up to two weeks while they are contagious.

James Hamlin, a Roanoke County man, died Oct. 8. The name of the other person who died has not been released. About 30 people have been so sick from the virus that they had to be admitted to hospitals.

Hepatitis A can be prevented with a vaccine. Vaccines are generally available from primary care providers, occupational health care clinics or health departments.

The Vests have retained Seattle food safety attorney Bill Marler to represent them in a case against Famous Anthony's. He is also representing about two dozen other families. Marler said the cases are moving forward. He has long advocated for restaurants and other foodservice operations to vaccinate their employees against the virus.

Hepatitis A is a highly contagious, vaccine-preventable, liver infection caused by the hepatitis A virus ranging in severity from mild infection lasting a few weeks to severe disease lasting several months, according to the Centers for Disease Control and Prevention.

The virus usually spreads when a person unknowingly ingests microscopic amounts of it from objects, food or drinks contaminated by an infected person. It can take up to 50 days for symptoms to develop.