No specific emergency department (ED) treatment is indicated for viral hepatitis, other than supportive care that includes intravenous (IV) rehydration. A liver abscess calls for IV antibiotic therapy directed toward the most likely pathogens and consultation for possible surgical or percutaneous drainage. Admit patients with hepatitis if they are showing any signs or symptoms suggestive of severe complications. Admit and evaluate for hepatic encephalopathy any patients with altered mental status, agitation, behavior or personality changes, or changes in their sleep-wake cycle. There is no specific therapy for acute hepatitis A infection. Therefore, prevention is the key. An effective vaccine is available and recommended for anyone with liver disease. It also is recommended for people planning to travel to areas of the world where sanitation may be less than optimal. Before receiving the vaccine, the patient usually will have a blood test to check whether antibody to the virus is present already, in which case vaccination is unnecessary. In people with possible exposure to hepatitis B, such as health care workers and sexual partners of infected persons, an effective vaccine exists and is recommended. In addition, the transmission of hepatitis B from mother to newborn largely can be prevented by vaccinating the infant and administering hepatitis B immune globulin.
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