If you have flu symptoms, stay home and away from other people rather than going to work in person. CDC’s current respiratory-virus guidance advises staying home when symptoms are not better explained by another cause, and its flu-prevention page says to go home as soon as possible if you become sick at work. Whether you can take paid leave, work remotely, or arrange coverage affects what is practical—but working from home is not the same as resting or taking sick leave.
What presenteeism means during flu season
Presenteeism means attending or working while ill. In this context, it can mean going to a shared workplace with flu or flu-like symptoms, or continuing to work remotely while sick. Those situations are not equivalent: remote work avoids exposing coworkers in person, but it may still prevent rest and recovery.
Presenteeism is also different from absenteeism, which means missing work. The two measures answer different questions: one concerns working while ill; the other concerns absence. For example, CDC’s analysis of the severe 2017–2018 U.S. flu season found that health-related workplace absenteeism rose sharply in November and peaked in January. That historical pattern is not a measure of how many people worked while ill, nor a forecast for every flu season. CDC MMWR absenteeism analysis.
What the evidence says about working while ill
There is no established current figure for all U.S. workers who work while ill with flu. The clearest quantified evidence in the sources here is a survey of healthcare personnel during the 2014–2015 influenza season, not a rate that should be applied to other occupations or to today’s workforce.
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In that national opt-in Internet panel, 1,914 healthcare personnel responded. Of those, 414 reported influenza-like illness, defined in the survey as fever plus cough or sore throat; 183 of the 414, or 41.4%, said they worked while ill. The median reported duration of working while ill was three days. The figure is self-reported and comes from a nonprobability panel, so it does not establish the prevalence among all healthcare personnel, much less all workers. The journal abstract reported the highest occupation-specific rates among pharmacists (67.2%) and physicians (63.2%), and the highest setting rate among hospital-based personnel (49.3%). CDC/NIOSH’s 2018 summary and the Chiu et al. study record.
In the NIOSH bulletin, medical officer Sophia Chiu, MD, MPH, wrote: “Working while ill, or presenteeism, increases the likelihood of influenza transmission to coworkers and patients.” Her statement addressed healthcare personnel; the practical concern about exposing others also matters in shared workplaces, but the survey’s numerical results should remain tied to its study population.
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Why people go to work sick
In the healthcare-personnel survey, respondents described both personal judgments and workplace constraints. Common reasons included believing they could still perform their duties, not feeling bad enough to miss work, doubting they were contagious, feeling professionally obligated to coworkers, and difficulty finding someone to cover their work. Long-term-care personnel most often cited being unable to afford lost pay. CDC/NIOSH’s summary of the survey.
These reasons point to more than an awareness problem. A reminder that flu spreads may not help someone who cannot afford an unpaid day or has no backup for essential duties. Leave, staffing, and workplace expectations influence whether staying home is feasible.
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What to do if you have flu symptoms
CDC’s current general respiratory-virus guidance says to stay home and away from others when respiratory symptoms are not better explained by another cause. Its seasonal flu-prevention page gives a direct workplace instruction: “If you begin to feel sick while at work, go home as soon as possible.” The page was updated September 1, 2026. CDC respiratory-virus guidance; CDC, “Healthy Habits to Prevent Flu”.
- If you are at home: Do not go to the shared workplace while you have respiratory symptoms. Follow current public-health guidance and your employer’s sick-leave procedure.
- If symptoms begin at work: Let your manager or designated contact know and leave as soon as practical, as CDC advises. Avoid close contact with others while arranging to leave.
- If you feel well enough to work remotely: Remote work can avoid on-site exposure, but it is still work. Take leave and rest if you need to; do not treat telework as a substitute for recovery.
- If you work in healthcare: Follow your facility’s occupational-health and infection-control rules. CDC recommends nonpunitive, flexible sick-leave policies that allow and encourage healthcare personnel with suspected or confirmed influenza to stay home. Patient-care settings can have requirements beyond general office guidance. CDC healthcare-setting guidance.
An archived CDC business page described staying home until at least 24 hours had passed since both overall symptoms began improving and fever had ended without fever-reducing medicine. Because that page is archived, treat that detail as dated workplace guidance, not as a timeless rule that replaces current CDC respiratory-virus advice or applicable healthcare-setting policies. Archived CDC business guidance.
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How leave and workplace norms relate to presenteeism
A CDC study of workers aged 19–64 who had medically attended acute respiratory illness or influenza during the 2017–2018 season found that access to paid leave was associated with fewer days worked during illness, both overall and at the usual workplace. Workers who said their employer discouraged coming in with influenza-like symptoms were less likely to attend their usual workplace. These are observational associations in a specific study population, not proof that any one policy will cause a particular result in every workplace.
The same study found that telework access was associated with more days worked overall while ill, but not with more days at the usual workplace. That distinction matters: telework may reduce in-person exposure even when it does not reduce the amount of work done while someone is sick. CDC Emerging Infectious Diseases study on paid leave, telework, and working while ill.
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What employers can do to reduce flu spread at work
Employers can make it practical—not just permissible—for workers to stay home. CDC advises employers to provide paid time off and develop flexible leave and telework policies so employees can stay home when sick or care for sick family members. CDC’s flu-prevention guidance also recommends cross-training coworkers to cover essential work, routine cleaning of frequently touched objects and surfaces, and maintaining basic hygiene supplies. CDC respiratory-virus guidance; CDC flu-prevention guidance.
- Make leave usable: Provide paid, flexible leave and communicate that employees should not come in with flu-like symptoms. In healthcare settings, make sick-leave policies nonpunitive and consistent with public-health guidance.
- Plan for coverage: Cross-train staff and identify backup coverage for essential work so a sick employee is not the only person who can perform a critical task.
- Offer remote work where appropriate: Let employees work remotely if they are well enough and their duties allow it, while making clear that they may instead take leave to rest.
- Make prevention accessible: Encourage annual flu vaccination and, where possible, provide convenient access. CDC identifies annual vaccination as the single best way to reduce seasonal flu risk and potentially serious complications.
- Keep hygiene supplies available: Maintain tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes. These are workplace prevention supplies, not treatment for flu and not a reason for someone who may be contagious to come in.
- Clean frequently touched surfaces: Establish routine cleaning for commonly handled objects and surfaces.
These steps work together: leave policies address income and attendance pressure, coverage plans address operational pressure, and supplies and vaccination support prevention. No single measure eliminates flu risk.
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