In early August 2021, cases of hepatitis A were diagnosed in Roanoke and in Alleghany County that were traced back to a specific restaurant chain.  To date there have been seventy confirmed cases with 26 hospitalizations and one fatality.  Given the long incubation period of hepatitis A it is possible that the current case number will increase together with the emergence of secondary cases within families or following close contact with shedders of the virus.  Investigation by health authorities ascertained that a restaurant worker was infected with hepatitis virus. He was in all probability responsible for infecting the patients in the cluster., as he worked at all three locations of the chain while presumably shedding virus

Given that hepatitis A is a serious disease with a clearly defined epidemiology, it is considered appropriate that all restaurant workers irrespective of their responsibilities should be vaccinated against hepatitis A. In many nations restaurant workers are screened on initiation of employment and at intervals for tuberculosis and Salmonella depending on prevalence of these infections.