Woong Chang was working as a bartender in an upscale Washington restaurant in 2009 when he started feeling symptoms of what turned out to be H1N1, or swine flu. Despite having a fever, a swollen throat and congestion that made it hard to breathe, he went to work. “Looking back on it now, I most definitely should not have gone into work, but I literally could not afford to miss a day,” he explains.

This year’s flu season may not be as bad as the H1N1 epidemic, but it has hit people hard nonetheless. By mid-January in the District, flu cases had already increased 300 percent beyond the 2011-12 season total. Influenza is a serious illness, and we should be serious about preventing its spread. One way to limit the transmission of viruses is to keep sick people at home and out of their workplaces. Individuals with paid sick leave are more likely to stay home to recuperate, sparing their co-workers and the public from exposure to their illnesses.

Unlike most developed nations, the United States does not require all employers to give workers paid sick days. The District is one of the few U.S. localities that do require paid sick leave (Connecticut, San Francisco and Seattle are the others), and that’s something to be proud of. But the District’s law includes an exception that’s terrible for public health: It excludes tipped restaurant workers.

Under the Accrued Sick and Safe Leave Act of 2008, D.C. employers must allow employees to earn paid sick leave, up to a total of three to seven days a year, depending on the employer’s size. But during the legislative process, the restaurant industry successfully lobbied for an exemption. As a result, restaurants do not have to offer paid sick leave to wait staff and bartenders who earn wages plus tips.

While the exclusion of tipped restaurant employees may have been politically expedient, it makes the law far less effective at stopping the spread of infectious disease. D.C. restaurants employ more than 36,000 workers, who come into daily contact with thousands more restaurant patrons. In a 2009-10 D.C. Restaurant Opportunities Center survey of restaurant workers, 79 percent said they lacked paid sick days and 59 percent reported preparing, cooking or serving food while sick. That’s a lot of servers potentially sneezing into your salad.

Why don’t servers and bartenders just stay home when they’re sick? With the national median earnings for wait staff at less than $9 an hour, many can’t afford to.

In 2009, Woong Chang dragged himself to work with a fever because he couldn’t afford to lose a day’s earnings. He wonders how many of his co-workers and customers caught swine flu from him — but he doesn’t know. His symptoms got worse, and he couldn’t make it in to work for several weeks. He ended up losing his job.

Restaurant workers shouldn’t have to choose between making the right choice for public health and losing pay and, potentially, their jobs. The District should strengthen its paid sick leave law to include tipped restaurant workers. Then we could all breathe a little more easily during flu season.

Celeste Monforton is a lecturer at the George Washington University School of Public Health and Health Services. Liz Borkowski is a researcher and master’s of public health candidate at the school. They are both members of the the Paid Sick Days for All coalition.