When to Stay Home

Maybe it began with a tickle in your throat or a stuffy nose. The next morning, you wake up coughing and sneezing, and are faced a serious dilemma: to work or not to work?

Everyone has a strong incentive to go to work every day—even when sick—whether it’s for an important meeting, today’s pay, or tomorrow’s promotion. However, sometimes it’s important for your health—and the health of others—to stay home. 

Find out what symptoms to look for to know when you’re contagious, and learn when it’s important to play it safe and stay home.

Find an internist or a pediatrician near you.

Cold, Flu, Allergies, or None of the Above?

Before you decide whether to go to work, it’s important to assess what might be causing your symptoms. If you are suffering from a sore throat, runny nose, and general feeling of exhaustion, but don’t have a fever, you could have a common cold, the flu, seasonal allergies, or a different virus altogether.

Both the common cold and the flu are caused by viruses. Viruses can easily spread from person to person—either through the respiratory system or through direct physical contact. If you have a cold or the flu, you are contagious. 

Unlike colds and flu, seasonal allergies arise from your body’s immune response to pollen. Allergies are not contagious. Therefore, if you know that allergies are causing your symptoms, you can safely go to work.

It is difficult to give a foolproof diagnosis without a definitive test such as a lab test for influenza pathogens or a skin test for allergies. However, this chart, compiled by the National Institute of Allergy and Infectious Disease, will give you an idea which symptoms tend to correlate with cold, flu, and allergies.

Symptom

Indicative of cold

Indicative of flu

Indicative of seasonal allergies

Cough

Often (moderate)

Often (severe)

Sometimes

Diarrhea*

Rarely

Sometimes

Never

Fatigue

Sometimes

Often

Sometimes

Fever/chills

Rarely

Often

Never

Headache

Sometimes/Rarely

Often

Rarely/Never

Itchy eyes

Rarely

Rarely

Often

Muscle/body aches

Sometimes (minor)

Often (severe)

Rarely/Never

Runny/stuffy nose

Often

Often

Sometimes

Sneezing

Often

Sometimes

Often

Sore throat

Often

Sometimes

Sometimes

Swelling of sinuses

Often

Rarely

Never

Vomiting*

Rarely

Sometimes

Never

*Diarrhea and vomiting occur more frequently in children, but are rare in adult flu cases (NIAD, 2012).

Still not sure what ails you? Consider these factors:

Exposure

If you’ve recently been exposed to someone with a cold, the flu, or another virus, it’s likely that you have a virus as well.

Season

Colds and the flu occur more frequently during winter months (October through April), while seasonal allergies are most common during spring and fall.

Duration

While cold and flu last three to 14 days, seasonal allergies often last for weeks. Grass pollen season, for instance, lasts six weeks.

Onset

While colds and allergies begin gradually, the flu often appears quite suddenly, as the patient experiences a headache, a severe cough, muscle aches, diarrhea, chills, and fever. “A person with the flu can often tell you the exact time of day that their symptoms started,” says Dr. Stephanie Vomouras, of Health Care Service Corporation.

Severity

“Classic influenza feels like you’ve been hit by a truck,” says Dr. James Malow, of Advocate Illinois Masonic Medical Center. 

If your symptoms indicate seasonal allergies, feel free to go to work. If your symptoms indicate cold or flu, you may need to stay home until symptoms improve.

Cold Versus Flu

If your symptoms indicate a cold and the flu, it is likely that you have a virus and are contagious. However, you might still feel well enough to go to work. Should you?

If you have reason to suspect the flu, do not go to work. Although cold and flu might initially cause similar symptoms, the flu can cause serious complications in some people, such as influenza encephalitis (swelling of the brain), pneumonia, kidney problems, and respiratory failure.

Thousands of people die each year of influenza and its complications.  In a 30-year study, the Centers for Disease Control and Prevention (CDC) reported that the number of deaths from influenza ranged from a low of 3,000 to a high of 49,000 (CDC, 2011). While you might recover from the flu without complications, you could spread the virus to someone who might not be so lucky.

Furthermore, while few drugs work reliably against colds, antiviral drugs, such as oseltamivir (Tamiflu), often work very effectively against flu. Better yet, as the antiviral drug starts to make you feel better, it will also make you less contagious. Antiviral drugs, however, work most effectively when taken within 24 to 48 hours of the first sign of illness. The bottom line? If you suspect you have the flu, stay home from work and don’t wait to go to the doctor.

Cold, Flu, and Workplace Safety

Whether you have a cold or the flu, you may decide to return to work while still contagious. If you have a cold, you may remain contagious for as long as you have symptoms. If you have the flu, you may remain contagious for up to seven days after becoming sick.

Because you may still be contagious, it’s important to know how to reduce your impact on others. Use the following simple tips to help keep everyone healthy:

  • Avoid direct contact. The less time you spend with co-workers, the less likely it is that you will make them sick.
  • Cover your cough (and sneezes). Because viruses travel through the air, “one way to stop the spread of illness is to practice respiratory etiquette,” says Dr. Daniel Levy of Mercy Medical Center.
  • Wash your hands. Whether you use soap and water or alcohol-based gel, hand hygiene prevents the spread of illness by contact.