Most People With Flu Don't Stay Home

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Survey Shows Two-Thirds of Americans Stick to Their Routines Despite Flu Symptoms

By Kathleen Doheny
WebMD Health News

Reviewed by Laura J. Martin, MD

Jan. 25, 2011 -- Staying home when you have the flu helps reduce the risk of others catching the disease, yet a recent survey finds that 66% of Americans go about their daily activities even after flu symptoms set in.

The same survey, however, revealed a double standard: 59% said they feel annoyed when others show up with flu symptoms, jeopardizing their own health.

"It's quite a paradox," says Susan Rehm, MD, medical director of the National Foundation for Infectious Diseases and vice chair of the department of infectious diseases at the Cleveland Clinic in Ohio.

The survey was conducted by the National Foundation for Infectious Diseases.

"We are clearly not practicing what we preach," Rehm tells WebMD. And our ''flu behavior" could use improvement, she says, along with our basic understanding of how flu is spread.

To help, the foundation has launched a campaign called "Are You that Guy?" that encourages personal and social responsibility by raising awareness of how easily the flu virus spreads.

While staying home with a cold is advisable, too, Rehm says it is crucial to avoid contact with others when you have influenza. "Flu is more than an inconvenience," she says. It's a serious disease, killing up to 40,000 people a year in the U.S., depending on the severity of the season.

Test Your Flu IQ

The flu survey, supported by Genentech, part of the Roche Group, included telephone interviews in November 2010 with 1,006 U.S. adults, ages 18 and older, who answered 13 questions.

Among the findings:

• 66% went about their daily activities, despite having symptoms of flu.
• 36% thought they could get the flu from getting the flu vaccine, although that is not possible.
• 40% said activities that needed to be done outside the house took priority over their concerns about spreading the virus.
• Most (68%) didn't know that a flu virus from a sneeze or cough can travel 5 or 6 feet.
• 44% thought they would be more likely to catch flu from touching something with the virus, such as a doorknob, although catching it is more likely by being around someone with it when they cough or sneeze.
• 10% of the respondents with a child in the house under age 18 said they had sent the child to school despite noticing flu symptoms.

Explaining Our Flu Behavior

Why do people go to work or school with flu symptoms? "They may be in denial," Rehm says. "They may not realize this is the flu and not a cold. They may not be aware of how it spreads, and there may be economic reasons."

To decide if you've got flu, Rehm suggested remembering the acronym FACTS:

• Fever
• Aches
• Chills
• Tiredness
• Sudden onset of symptoms

"If you start getting flu symptoms, contact your health care provider quickly," she says. It may be possible to prescribe an antiviral medication to help you feel better faster.

Second Opinion

The survey findings are no surprise to Peter Galier, MD, attending physician and former chief of staff at Santa Monica -- UCLA Medical Center & Orthopaedic Hospital, Calif., and associate professor of medicine at the UCLA David Geffen School of Medicine. He reviewed the findings for WebMD.

''People don't realize how far microscopic snot flies," he says. Nor do they realize how much they touch objects others touch during the course of a day, potentially picking up the virus that way, he says.

''Stay home when you are sick,'' he says. "Have plenty of hand sanitizer around." Use disposable tissues, he suggests, and clean your workplace often. You can use alcohol swabs to clean your keyboard and phone, he says.

In a public restroom, he says, faucets can have the virus on them. But motion-controlled faucets and towel-dispensers are becoming more common, making contact with faucets and towel dispensers unnecessary.

When Do You Stop Being Contagious?

How do you know when you can return to work?

For flu, Galier says, "you have to have no fever for 24 hours without taking medication for fever'' to consider yourself not contagious.

Rehm agrees. "'For people who are [typically] healthy, once the fever is gone the risk of contagion is gone or going," she says. "Those with compromised immune systems [due to HIV, for instance] can shed the virus longer."

"If you still feel bad after the fever is gone, stay home one more day," she suggests.

SOURCES: Susan Rehm, MD, medical director, National Foundation for Infectious Diseases; vice chair, department of infectious diseases, Cleveland Clinic, Ohio.Survey, National Foundation for Infectious Diseases, November 2010.Peter Galier, MD, former chief of staff and attending physician, Santa Monica -- UCLA Medical Center & Orthopaedic Hospital, Calif.; associate professor, UCLA David Geffen School of Medicine.

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