SAN DIEGO -- Four more hepatitis A cases with a possible link to a Chipotle restaurant in La Mesa have been confirmed, bringing the number to 18, the San Diego County Health and Human Services announced Monday.

Anyone who ate at the Chipotle on Fletcher Parkway between March 1 and April 22 and has symptoms of hepatitis A is being asked to see a doctor to get screened for the disease.

Twenty-six restaurant employees have been tested, and all have been negative for hepatitis A, which is spread through poor hygiene and often when someone consumes contaminated food or water, according to the HHSA.

Symptoms of the disease include fever, fatigue, loss of appetite, nausea, abdominal discomfort, dark urine and jaundice, according to the HHSA.