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As we all know by now, this year's flu season struck early and hard. And that's creating a particular problem for businesses. If they tell too many sick employees to stay home, work doesn't get done. But then, if people with flu come to work, other workers could get sick.

NPR's Ailsa Chang has today's Business Bottom Line.

AILSA CHANG, BYLINE: They call him Patient Zero. Meet Chaim Gross. He works at Zeno Radio, a media technology company in Manhattan. Gross was the first one in his office to get sick about three months ago, but he kept coming to work.

CHAIM GROSS: And then, as I started feeling better, David started getting sick. And then he was stuck at home for, like, three days, throwing up and everything. And then...

CHANG: And then half of the 20 workers here started dropping like flies.

GROSS: And then Keith went home sick. Jack was actually out before. Sorry, I missed one. Jack was out...

CHANG: Yeah, Jack was out. And now, thanks to the domino effect Gross says he might have set in motion, Deanna Mitchell from sales and marketing gets the flu. But she shows up to work today, too.

DEANNA MITCHELL: I really wanted to come in, because today was important meetings.

CHANG: Every worker at Zeno Radio receives six sick days a year, but it doesn't matter. Gross says he's only taken one day off in the last eight months, even after becoming the walking plague. Why? Because he says his small company needs him, and he loves hanging out with his colleagues.

Even if you're getting your colleagues sick.

GROSS: Yeah. Yeah.

(LAUGHTER)

TEVI TROY: This puts employers in a bit of a bind, because on the one hand, they need to get work done, and they will fall behind if the work is not done.

CHANG: That's Tevi Troy, a former deputy secretary for Health and Human Services.

TROY: But if you encourage people to come into the office, or people feel pressured to go into the office, they might spread the flu and make the situation worse.

CHANG: So here's the advice businesses are now getting: Reduce your meetings, maybe even set up three-foot buffer zones around sick workers, or just tell your flu-stricken employees to work from home. But for some businesses, working from home just isn't an option. Take SmartSitting. It's a nanny and baby-sitting agency based in Brooklyn. Lauren Kay runs the business, and says almost 20 percent of her sitters have called in sick the last three weeks.

LAUREN KAY: Generally, it's a baby, and a sitter goes and gets the flu from the baby. And then the sitter then has to cancel a number of future appointments because they're sick. It's really like all of New York City has sort of been tied together by a network of sitters, and everyone's just trying to stay healthy and...

CHANG: Kay's agency has been stuck finding replacements at the last minute. But for the nannies who missed work, it's up to parents to decide whether to pay them sick days. Kay says many parents do, but a lot of sitters don't feel empowered to ask for those days.

KAY: It's hard to inconvenience a family and say, hey, I can't come in for work tomorrow. And also, can you pay me?

CHANG: The workers who do get paid when they're out sick are the lucky ones. John Challenger says about 40 percent of workers today actually don't get sick days, and that's why so many work while under the weather. Challenger runs an outplacement firm.

JOHN CHALLENGER: The economy is still on shaky ground, and many workers continue to be worried about losing their jobs, and so they're reluctant to call in sick or even use their vacation days.

CHANG: And the combination of those sick employees infecting others at work and the sick workers staying at home for days means businesses pay a high price during these sneezy months. The Centers for Disease Control and Prevention says the flu costs employers about 10-and-a-half billion dollars every year in health care expenses and lost productivity.

But some employers are fortunate, like Morris Berger, the boss at Zeno Radio. He says productivity actually didn't slow down much this winter.

MORRIS BERGER: No, I think it's getting better, actually. So maybe we don't need all these employees.

(LAUGHTER)

CHANG: What happened to save the company was a nice stroke of luck. Chaim Gross says the flu only toppled one person at a time.

GROSS: It's like a round-robin. Rockin' Robin, rock, rock. I just like the microphone. I'm sorry. I'm sorry.

CHANG: At this point, I could feel Gross' breath on my face, and I started wondering: Maybe I've been sitting in this office a little too long. I didn't shake his hand on my way out. Ailsa Chang, NPR News, New York.

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