Updated 03 June 2015

When you’re too sick to work

You’ve caught a bug. Are you well enough to drag your sniffling self into the office? Or will you be putting your and your colleagues’ health at risk? Find out.


We’ve all encountered those overcommitted colleagues who come to work despite looking like a walking incubus of viral plague. They pass you in the passage, all red-faced and sweaty, and even extend a clammy hand to greet you... Yuck! Before you reach for your hand sanitiser, spare a thought as to why some employees feel compelled to come to work when they’re clearly ill and risk infecting their colleagues. After all, you may have done the same thing at some point in your career. Some experts believe it may have to do with the pressures of our jobs.

“Most of my patients have reported that they cannot stay at home when they’re ill due to their work loads and deadlines,” says Dr Lindi Raschke, a GP based in Pretoria, South Africa.

She also suspects that, in some instances, supervisors frown upon workers staying at home, so ill workers feel compelled to go to work rather than taking a day or two off to recuperate.

Work pressures have inadvertently created a global trend known as “presenteeism” (when someone goes to work when they shouldn’t be there), and South Africans are right up there in terms of numbers. According to a survey, South Africans won’t let a cold or flu get the better of them with 8 in 10 determined to go to work even though they’re as sick as a dog.

“We live in a world where work doesn’t stop, so people try to work through their illness. They don’t think they’ll make their colleagues sick, but instead think about all the work that needs to be done,” says Jeannine Scheltens, divisional human resources (HR) manager for a leading South African media company.

Unfortunately, our conscientiousness sometimes has a downside. Apart from endangering your colleagues when you go to work sick, you may also be putting your own life at risk. Flu, for one, can be life-threatening under certain circumstances. And so can many other diseases…

So, when are you (or one of your colleagues) too sick to go to work?

Check yourself before you wreck yourself

Let’s face it, colleague, the wheels of industry will continue turning even during your brief absence from work, and medical experts all agree that if you’re not likely to be productive, are contagious, or if you’re a possible danger to others while sickly (for example, if you’re a bus or taxi driver or operate heavy machinery), you should be at home resting.

Gastroenteritis, for example, is highly contagious and in some infected individuals might need to stay home for at least 24 hours after symptoms (e.g. diarrhoea, nausea, stomach cramps, headache, fever and vomiting), or 48 hours if you live or work in a high-risk setting, such as a health-care facility, a residential care facility, a child-care facility, or if you handle food as part of your job.

When you have flu-like symptoms (e.g. fever, cough, sore throat, headache, fatigue), the US Centers for Disease Control and Prevention (CDC) recommends you stay home for at least 24 hours after the fever has subsided, except to get medical care or other necessities. The fact is that you’re contagious and that, if you don’t rest, you may be slowing down your recovery process.

Colds are mostly not severe enough to keep you from work, says Health24’s Dr Owen Wiese. You are, however, contagious, so apply the hygiene tips below in order to prevent your cold from spreading.

Occasionally a bout of flu will make you feel very miserable. Your doctor might then consider booking you off for a day or two.

If you have bronchitis, another common winter infection, your doctor will most likely book you off for a couple of days, notes Dr Wiese. If this is the case, it’s important to heed your doctor’s advice and rest.

Seek help early

Apart from containing the infection (i.e. not spreading the disease to others), resting at home and seeking immediate medical care can also help prevent life-threatening complications. Britain’s Treat Yourself Better Campaign recommends medical intervention in cases where:

- Your symptoms are so bad that they severely affect your quality of life and prevent you from functioning normally.

- You experience a sore throat that doesn’t get better within 10 to 14 days. This may suggest glandular fever (a viral infection with unpleasant symptoms, including nausea and swelling around the eyes, which can last several weeks).

- You have a persistent high temperature over 38oC for more than three days that doesn’t lower even if you take paracetamol or ibuprofen. ·         You’re confused or disorientated.

- You cough up blood-stained phlegm (thick mucus).

- You have an earache and notice fluid leaking from the ear.

Practice good hygiene

Unfortunately, contagious diseases are a fact of life. It’s not possible to steer absolutely clear of germs, even if you and most of your colleagues apply all the rules described above.

For this reason, it’s important to take extra care when you’re at the office or in public spaces. These tips, adapted from a Kimberly-Clark Professional publication, will help keep you healthy throughout the year: - Wash your hands regularly – this cannot be overemphasised.   - Ask your HR department to provide tools to help break the chain of germ transmission in the office. Ask for hand sanitiser, disinfecting wipes, paper towels, soap and facial tissues – and use them often. - Cover your nose and mouth with a tissue when you cough or sneeze, and encourage sick colleagues to the same. If you don’t have a tissue handy, cough or sneeze into the inner part of your sleeve at the elbow. - Keep anti-viral tissues on hand (e.g. from Kleenex). These have a special moisture-activated middle layer that traps and kills cold and flu viruses.

And don’t forget to vaccinate!

Read more:

Sick leave myths busted

When are you too sick for work?

Avoiding the killer flu


- Reviewed by Dr Lindi Raschke, general practitioner, South Africa
- Influenza Specialist Group (Survey)
Jeannine Scheltens, divisional HR manager, Media24
- Treat Yourself Better,
- Kimberly-Clark Professional
- CDC, Gastro:
What Should I Do If I Get Sick?
- Western Australia’s Department of Health
- CDC, The Flu: What Should I Do If I Get Sick?,


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Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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