The cycle never seems to stop. The CDC warns sick employees with flu symptoms to stay home from work. The workers ignore these warnings, consistently. Why can't people stay home from work when they're sick?

This "presenteeism" that makes you struggle into your job when you've got a bad cold or the flu can stem from subtle pressure from co-workers, friends or family members. Or maybe you work where a full-blown company culture discourages employees from using sick leave. Temporary workers are more likely to work sick, and presenteeism is also more common among young and middle-aged workers, according to a 2019 study published in the International Journal of Environmental Research and Public Health.

Employees took just 2.5 sick days in 2018, according to LinkedIn data, with almost one in five saying they simply could not afford to skip even one day of getting paid. Those in the 18-34 age bracket were more than three times as likely to provide the "can't afford to stay home" rationale.

No matter the back story, the result is the same: communicable illnesses that spread like the proverbial wildfire. "Those 80,000 people who died from flu last year? Guess what? They got it from someone. Someone gave them the flu," Surgeon General Jerome Adams, MD, said during a CDC news conference urging flu precautions in 2018.

And presenteeism is also leading to an epidemic of employees who spend flu season sick and the rest of the year burned out.

"This trend of working while out of the office can easily lead to burnout, which can have negative long-term effects on productivity and employee health," Glassdoor Community Expert, Amelia Green-Vamos explained in Market Watch.

But will that threat stem the tide? Probably not, according to Forbes. "We live in a fast-paced society filled with workers who don't want to slow down long enough to take a vacation, much less miss work due to illness," it warned. "Yet people are feeling the strain of both choices. Whether it's stress-related illnesses from skipping vacations and working long hours or struggling to fight off a cold for weeks instead of days because we refuse stop and give our bodies downtime."

While it would be really great if workers could simply stay home when they're ill, as per the employee handbook, the reality is sick days can hurt your reputation and chances of promotion. At a workplace designed for people who never get sick or show up and cough and puke their way through the day, you could be viewed as the weak link if you don't do the same. There's no ideal way to balance the conflicting demands of staying healthy and a workplace that wants you there, sick or not. Should you stay home from work when you're sick? Here are four factors to weigh when you make your decision:

The CDC is on your side. Just so you know, the government entity with "disease control" right in the title recommends "all employees should stay home if they are sick until at least 24 hours after their fever (temperature of 100 degrees Fahrenheit or 37.8 degrees Celsius or higher) is gone." You're supposed to take your temperature before taking any OTC meds. Even if you, or your doctor, simply suspects flu, you're supposed to "stay home from work at least 4-5 days after the onset of symptoms," the CDC adds. "Persons with the flu are most contagious during the first three days of their illness." That's not happening for most employees, though.

Employers don't have to offer you sick leave. Employers don't have explicit duties in this matter, according to the Workplace Fairness organization, which aims to demystify legal jargon surrounding worker treatment policies. "According to OSHA, the law that requires employers to provide a safe workplace, your employer does have a duty to protect you from recognized hazards," WF explained. "However, there is no specific duty that details what an employer must do to protect you from an infectious disease."

That's about what you'd expect in a country that does not require companies to provide paid sick leave in the first place. While there are situations where the Family and Medical Leave Act provides up to 12 weeks for unpaid sick leave, that's unlikely to help you if you'd really like to heal from this hacking cough and high fever before going back to work.

If you're going to take a sick day, don't try to work from home. Wait, what? Yes, it's true, even if your employer allows you to occasionally work from home, it's not a good idea to do this in combination or in lieu of a sick day. "You do yourself and your company a disservice when you use a work-from-home day as a way to be lazy or as a pseudo sick day. You don't want to set that precedent," LaMotte said. "If you're not doing your job as you normally would, and you're not producing the way you normally would, consider that a sick day. You're just not going to get better. In some cases, the key to recovery is sleep, and the only way to do it is to take the time off you deserve."

You owe it to your family. According to Savvy Mom, it's harmful to take sick leave to care for an ailing family member but then show up at work when you get sick yourself. "You answer emails from bed, check the status of work projects, make your kids a quick dinner (even if the smell of food makes your stomach turn over) and help them with bathtime. It's not just working moms who do this – stay-at-home mothers do it, too. It's universal," the blog noted. "Sure, you've got a fever of 102, a throat that feels like knives and a headache that might kill you, but it's nothing a quick shower and another dose of ibuprofen won't solve."

That attitude can topple the entire family's health, though. "Time and time again, moms are reminded that you cannot pour from an empty cup," SM noted. "We need to take sick days when we're sick...Call upon your village, if you have one. Tell your boss you need another sick day (this time for you) and be amazed when the world doesn't fall apart. Take care of yourself without feeling guilty about it."