Our daughter Julia, who is 13, is one of those people at risk. Julia has an autoimmune disease I couldn’t even pronounce when she was diagnosed 10 years ago. The shortened versions are APS Type 1, or APECED. The disease is a cruel and complex combination of autoimmune attacks on various organs. It makes patients vulnerable to lung and yeast infections, as well as parathyroid and adrenal failure.
It took years for an amazing team at SickKids Hospital in Toronto and the National Institutes of Health in Bethesda to get a handle on how to manage Julia’s symptoms. Now, she is doing really well. But each winter we watch in frustration as we see people make the sick march to work.
You know who you are. You wake up feeling lousy. You are clammy and have a sore throat and horrible cough. You take two Tylenol, have a cup of tea and head to work. You don’t like the other options. You would miss out on something that seems important at the time, or you may disappoint your boss or your co-workers.
You are pushing through the day even though if you stopped to think about it for a moment, you would admit that you should be home in bed. You may even have the flu. I know your kind. I was your kind. I was committed to work, my employer, my colleagues and my clients, over my own health. I was sure that I would be fine.
After dealing with Julia’s health problems, I am all too aware how reckless this is. Now I stay home when I’m sick. But I don’t always see my friends doing the same.
The flu season this year emerged earlier than usual, which is bad news for our health-care systems but particularly bad news for those whose immune systems aren’t working at full strength. These are people who were born with immune deficiencies, folks who have weak immune systems because of medical treatments such as chemotherapy, the elderly and those precious ones who were literally born yesterday.
Immune deficiencies are not obvious. They are mostly invisible conditions. But they affect more than just the individual. They affect families. If I get the flu, it is impossible for me to care for my daughter — not only because I am sick, but also because my presence in our home puts her in jeopardy.
My life changed when Julia was diagnosed with APS Type 1. Infections were a regular part of her life, and they were debilitating. For a couple of years, she was in the hospital more than she was out. Her doctors warned us about the particular risks of chickenpox and the flu.
In fact, Julia was hospitalized with the flu one week before her eighth birthday. An extremely high fever and horrible cough hit her so hard that within 12 hours we were rushing to the emergency room. She became incredibly weak, whereas she had been bouncing around in the days before. The nurses and doctors suspected the flu — mainly because of how quickly the illness affected her. She needed oxygen, IV fluids and to be isolated in a special room. No visitors other than her parents were allowed. We were told that there are not many medical options to help fight the flu. Thank goodness, she recovered.
Now we send a letter to my daughter’s entire school every fall telling families about Julia’s illness and asking them to get the flu and chickenpox vaccines and not send their kids to school sick. We tell our friends and cancel plans when there is a chance that we could be exposed to the flu. And of course, we get our flu shots.
Despite our effort to be open about the risk of the flu to Julia, people in our circle still don’t stay home when they’re ill. They confess to us in hushed tones that maybe they should have, or we hear about it from others. Sometimes people are incredibly supportive and empathetic. Sometimes people seem frustrated with the fact that we have caused them an inconvenience.
People need to reexamine their urge to be physically present at work or school when they have a contagious illness. Employers should reevaluate their policies and set examples for their employees. It will save them money. According to the CDC, the U.S. economy loses $16.3 billion in lost earnings every year because of the flu. Employees and students should know that self-care will be respected.
This year alone since October, nearly 6,500 people have been hospitalized, many of them adults older than 50 and children younger than 4, according to the CDC. The agency said 20 children have died during the current flu season.
I hear the concern that some people abuse sick days, but I see more people pushing through illness to get to work or their kids to school. We can be hard-working people and caring neighbors at the same time, and we need recognize that the way we act affects the health of others.
It is not always easy to know whether you are “sick enough” to stay home, but the sudden onset of a sore throat, fever, cough and fatigue are some of the symptoms that distinguish the flu from the common cold. And please, if you have a fever, don’t go to work or school. A fever is a clear sign of an infection and contagion. The CDC recommends staying home for 24 hours after your fever is gone without the help of fever-reducing medication.
It’s okay to stay home when you’re sick. If you don’t want to do it for yourself, do it for the rest of us.
Jennifer Orange is the parent of a child with an immune deficiency and sits on the board of the APS Type 1 Foundation.