Occ Med Guidance: Returning to Work After a Respiratory Infection
In recent weeks I've noticed that many staff members were recovering from upper respiratory infections (usually a cold). I've received questions about the criteria for safe return to work during convalescence from such illnesses.
This can be a difficult decision. It's not necessary or feasible to require yourself to be completely asymptomatic before returning to work. For instance, sometimes cough can persist for many weeks. Such "post bronchitic coughs" aren't contagious the way early-stage coughs are.
Here are my suggestions:
- Don't return to work until you feel well enough to do so.
- Don't return if, off medication, you have muscle aches because those strongly imply that you are still contagious.
- Most importantly, don't return if, off medication, you have a fever. Define fever as an elevation above the temperature range that's typical for you when you aren't ill. For instance, often your temperature is measured during routine visits to your physician. If you don't have a feel for your non-ill baseline temperature, then assume it is 98.6 F and consider fever to be 99 or higher. There are medical operational definitions of fever. For instance to some physicians, fever is 1.5 degrees above baseline. I don't recommend bothering with these definitions. Most of them are intended for use in triggering medical interventions. The most protective definition for return to work is the one I mentioned above.
- There are many exceptions. For instance prolonged cough can be from TB (tuberculosis), not post-bronchitic convalescence. Fever can be from cancer. My suggestions assume the context of an uncomplicated cold-like illness.
- If you aren't sure whether you can safely return to work, you can consult your personal physician or call Occ. Med. at ext. 7539 or 5585.
Thanks. Please let me know if you have any questions.
W. Smith Chandler, MD, MPH, MS
Site Occupational Medicine Director