When you have flu symptoms, the safer choice is to stay home and away from other people. If symptoms start at work, CDC says to go home as soon as possible. Whether workers can follow that advice often depends not just on how sick they feel, but on paid leave, job coverage and workplace expectations.
What presenteeism means during flu season
Presenteeism means attending work or continuing to work while ill. It is different from absenteeism, which means missing work, and from remote work: someone working from home may still be working while sick, but is not exposing coworkers at the usual workplace.
There is no universal current estimate for how many workers across all occupations work through flu. The clearest quantified example here is a self-reported survey of U.S. healthcare personnel during the 2014–2015 influenza season, not a rate that can be applied to every job or season.
How often did healthcare personnel work while ill?
In a national opt-in internet panel of 1,914 healthcare personnel, 414 reported influenza-like illness, defined for the survey as fever plus cough or sore throat. Of those 414, 183—41.4%—said they worked while ill; the median reported duration was three days. The study also found that 21.6% of all respondents reported influenza-like illness. These were self-reported results from a nonprobability panel, so they do not establish the rate among all U.S. workers. CDC/NIOSH’s 2018 summary describes the findings; the original study record reports the occupation and workplace-setting differences.
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Within that survey, the abstract reported the highest occupation-specific rates among pharmacists (67.2%) and physicians (63.2%); hospital-based personnel had the highest setting rate (49.3%). Those figures describe subgroups in the same 2014–2015 healthcare-personnel survey, not present-day rates for those occupations generally.
Why people go to work with flu symptoms
Survey respondents described several reasons for working while ill. Many felt able to perform their duties, did not feel sick enough to miss work, or doubted that they were contagious. Others cited professional obligation to coworkers or difficulty finding someone to cover their shift. Healthcare personnel in long-term care most often cited being unable to afford lost pay. NIOSH’s summary of the survey shows why a warning about contagion alone may not overcome practical and financial barriers.
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What current CDC guidance says to do
CDC’s general respiratory-virus guidance advises staying home and away from others when respiratory symptoms are not better explained by another cause. It also calls on employers to provide paid time off and develop flexible leave and telework policies so people can stay home when sick or care for sick family members. See CDC’s precautions when sick guidance.
For flu prevention specifically, CDC says to go home as soon as possible if you begin to feel sick at work. Its Healthy Habits to Prevent Flu page, updated September 1, 2026, also recommends annual flu vaccination and everyday prevention actions. An older, archived CDC business page gives a more specific return-to-work benchmark: stay home until at least 24 hours have passed since both overall symptoms began improving and fever ended without fever-reducing medicine. That page is archived, so treat the timing as dated workplace advice rather than a universal current rule; follow current public-health, employer and clinical guidance for your situation. Archived CDC workplace guidance.
How leave and workplace norms affect working while sick
A study of workers aged 19–64 with 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. Telework access was associated with more days worked overall while ill, but not with more days at the usual workplace. These are observational associations in a specific study population, not proof that a particular policy causes a given outcome. The study in Emerging Infectious Diseases.
For personal finances, paid leave can make following stay-home advice more feasible by reducing lost income; access alone does not guarantee that every worker can use leave or that a workplace has adequate coverage. Telework can keep a sick employee away from coworkers, but working remotely is not the same as taking time off to rest.
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What employers can put in place
CDC guidance points to prevention measures that address both exposure and the obstacles workers report:
- Make staying home practical. Provide paid time off and flexible, nonpunitive leave policies, and communicate clearly that symptomatic employees should not come in.
- Plan for coverage. Cross-train coworkers and identify backup coverage for essential duties so one person’s absence does not leave a shift or service without support.
- Offer vaccination access. CDC identifies annual flu vaccination as the best way to reduce seasonal flu risk and potentially serious complications. Employers can make access easier, including by offering workplace vaccination where available.
- Maintain everyday supplies. Keep tissues, soap, paper towels, alcohol-based hand rub and disposable wipes available, and routinely clean frequently touched objects and surfaces. These supplies support prevention; sanitizer does not treat flu or make it safe to work around others while contagious.
- Use telework appropriately. When someone feels well enough to work and the job allows it, remote work avoids attendance at the usual workplace. It should not be treated as a substitute for sick leave when a person needs rest.
These measures align with CDC’s workplace flu-prevention recommendations and its employer guidance on leave and telework. CDC’s health-care guidance specifically recommends flexible, nonpunitive sick-leave policies that let healthcare personnel with suspected or confirmed influenza stay home; clinical settings should also follow occupational-health and facility infection-control requirements. CDC guidance for healthcare settings.
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Keep flu-related work absence figures in context
Health-related workplace absenteeism rose sharply in November and peaked in January during the high-severity 2017–2018 U.S. flu season, according to a CDC analysis. That finding concerns missed work, not presenteeism, and describes one historical season rather than a forecast for every year. CDC’s 2019 MMWR analysis.
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