Recommended Employer Responses for the 2010-2011 Flu Season from the Center For Disease Control

Sick persons should stay home

• Advise workers to be alert to any signs of fever and any other signs of influenza-like illness⁶before reporting to work each day, and notify their supervisor and stay home if they are ill. Employees who are ill should not travel while they are ill.
• CDC recommends that employees with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8° C] or greater), or signs of a fever, without the use of fever-reducing medications.
• Expect sick employees to be out for about 3 to 5 days in most cases, even if antiviral medications are used.
• Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are well aware of these policies.
• Talk with companies that provide your company with contract or temporary workers about the importance of sick workers staying home and encourage them to develop non-punitive leave policies.
• Do not require a doctor’s note for workers who are ill with influenza-like illness to validate their illness or to return to work, as doctor’s offices and medical facilities may be extremely busy and may not be able to provide such documentation in a timely way. 
• Employees who are well but who have an ill family member at home with influenza can go to work as usual. However, these employees should monitor their health every day, and notify their supervisor and stay home if they become ill. Employers should maintain flexible policies that permit employees to stay home to care for an ill family member. Employers should be aware that more workers may need to stay at home to care for ill children or other ill family members than is usual.

Sick employees at work should be asked to go home

• CDC recommends that workers who appear to have an influenza-like illness upon arrival or become ill during the day be promptly separated from other workers and be advised to go home until at least 24 hours after they are free of fever (100° F [37.8° C] or greater), or signs of a fever, without the use of fever-reducing medications.
• Those who become ill with symptoms of an influenza-like illness during the work day should be:
• Separated from other workers and asked to go home promptly. (For recommendations on personal protective equipment for a person assisting the ill employee, seeWhen possible and if they can tolerate it, workers with influenza-like illness should be given a surgical mask to wear before they go home if they cannot be placed in an area away from others.
• If an employee becomes ill at work, inform fellow employees of their possible exposure in the workplace to influenza-like illness but maintain confidentiality as required by the Americans with Disabilities Act (ADA). For more information on privacy issues, please refer to: http://www.flu.gov/faq/workplace_questions/equal_employment/index.html#PrivacyIssues. Employees exposed to a sick co-worker should monitor themselves for symptoms of influenza-like illness and stay home if they are sick.

Cover coughs and sneezes

• Influenza viruses are thought to spread mainly from person to person in respiratory droplets of coughs and sneezes. Provide employee messages on the importance of covering coughs and sneezes with a tissue or, in the absence of a tissue, one’s sleeve. Place posters in the worksite that encourages cough and sneeze etiquette.
• Provide tissues and no-touch disposal receptacles for use by employees.

Improve hand hygiene

• Influenza may be spread via contaminated hands. Instruct employees to wash their hands often with soap and water or use an alcohol-based hand cleaner, especially after coughing or sneezing. Place posters in the worksite that encourage hand hygiene.
• Provide soap and water and alcohol-based hand sanitizers in the workplace. Ensure that adequate supplies are maintained. If feasible, place hand sanitizers in multiple locations or in conference rooms to encourage hand hygiene.

Clean surfaces and items that are more likely to have frequent hand contact

• Frequently clean all commonly touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
• No additional disinfection beyond routine cleaning is recommended.

Encourage employees to get vaccinated

• Encourage your employees to get vaccinated for seasonal influenza. For information on groups prioritized for seasonal influenza vaccines, please see http://www.cdc.gov/flu/protect/keyfacts.htm. 
• Encourage your employees also to get vaccinated for 2009 H1N1 influenza when vaccines are available to them. Different groups are prioritized for 2009 H1N1 influenza than for seasonal influenza. For information on groups prioritized for H1N1 influenza vaccine please see http://www.cdc.gov/h1n1flu/vaccination/acip.htm.
• Offer opportunities at your worksite for influenza vaccination. Consider granting employees time off from work to get vaccinated if not offered at the worksite.
• Review the health benefits you offer employees and work with insurers to explore if they can cover the costs of influenza vaccination.

Take measures to protect employees who are at higher risk for complications of influenza

• People at higher risk for complications from influenza include pregnant women; children under 5 years of age; adults and children who have chronic lung disease (such as asthma), heart disease, diabetes, diseases that suppress the immune system and other chronic medical conditions; and those who are 65 years or older.⁷
• Inform employees that some people are at higher risk of complications from influenza and that if they are at higher risk for complications, they should check with their health care provider if they become ill. Early treatment with antiviral medications is very important for people at high risk because it can prevent hospitalizations and deaths.
• Encourage employees recommended for seasonal influenza vaccine .
• Employees who become ill and are at increased risk of complications from influenza and ill employees who are concerned about their illness should call their health care provider for advice. Their health care provider might want them to take antiviral medications to reduce the likelihood of severe complications from the influenza.

Prepare for increased numbers of employee absences due to illness in employees and their family members, and plan ways for essential business functions to continue.

• Employers should plan to monitor and respond to absenteeism at the workplace. Implement plans to continue your essential functions in case you experience higher than usual absenteeism. Elevated absentee rates can be due to sick workers, those who need to stay home and care for others, or from workers with conditions that make them at higher risk for complications from influenza and who may be worried about coming to work.
• Cross-train personnel to perform essential functions so that the workplace is able to operate even if key staff are absent.
• Assess your essential functions and the reliance that others and the community have on your services or products. Be prepared to change your business practices if needed to maintain critical operations (e.g. identify alternative suppliers, prioritize customers, or temporarily suspend some of your operations if needed).

Advise employees before traveling to take certain steps

• Advise workers to check themselves for fever and any other signs of influenza-like illness before starting travel and notify their supervisor and stay home if they are ill.

• Advise employees who will be traveling or on temporary assignment about precautions they may need to take to protect their health and who to call if they become ill.
• Employees who become ill while traveling and are at increased risk of complications from influenza and others concerned about their illness should promptly call a health care provider for advice.
• Ensure employees who become ill while traveling or on temporary assignment understand that they should notify their supervisor.
• If outside the United States, ill employees should follow your company’s policy for obtaining medical care or contact a health care provider or overseas medical assistance company to assist them with finding an appropriate health care provider in that country, if needed. A U.S. consular officer can help locate health care services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or give medications, vaccines, or medical care to private U.S. citizens overseas.