Businesses should encourage employees to stay home sick at the first symptom of swine flu and should drop requirements for doctor's excuses during flu season, U.S. officials said on Wednesday.

Employers should also encourage vaccination against both seasonal and H1N1 swine flu, the officials said.

If an employee stays home sick, it is not only the best thing for his health, but it is also the best thing for his co-workers, Commerce Secretary Gary Locke told a news conference.

Requirements to get a doctor's note to validate illness should be waived, Locke said. It has the potential to overload the healthcare system that is likely to be stressed during this year's flu season, he said.

The new H1N1 influenza virus has caused the first pandemic of the 21st century, according to the World Health Organization. When the northern hemisphere's autumn weather sets in it is expected to worsen.

In releasing official federal government guidance on influenza for businesses, Locke and other Cabinet secretaries also urged a little education about hygiene and vaccination.

We hope that employers will do some outreach to employees, Health and Human Services Secretary Kathleen Sebelius said. Employers should also encourage workers to wash their hands and use hand sanitizer, she said.

People need to learn to use a sleeve or an arm to cover their coughs, not a hand, and Sebelius asked businesses to take a lead on education, as well as keeping work surfaces clean so the virus does not spread from tables or telephones.

CROSS-TRAINING

Homeland Security Secretary Janet Napolitano encouraged cross-training to make sure important work goes forward even if employees are sick, especially in critical infrastructure businesses such as utilities. We are now asking the business community to be proactive and do some planning too, she said.

If the flu season worsens, Locke said companies need to plan for continuity of operations. Plans need to be put into place now for teleworking and working in place, he said. Companies also need to plan to reduce unnecessary travel and limit face-to-face meetings, and perhaps spread workstations farther apart.

Flu, marked by sudden onset of high fever, sore throat, coughing and muscle aches, is spread on small droplets across a space of about 3 to 6 feet or picked up on surfaces.

H1N1 can spread before a person shows symptoms, but Sebelius said after a patient's fever has been gone for 24 hours it is safe to come back to work or school.

Although most cases are mild to moderate, H1N1 appears to be about as deadly as seasonal flu, which kills about 36,000 people a year in the United States and up to 500,000 globally. WHO predicts a third of the population will be infected in a short two-year period.

Five companies are making both seasonal and H1N1 flu vaccines for the U.S. market -- AstraZeneca's MedImmune unit, CSL, GlaxoSmithKline Plc, Novartis AG and Sanofi-Aventis SA.

HHS says 45 million doses of the H1N1 vaccine will be on hand in mid-October, when mass vaccination is planned.

HHS has also bought 84 million courses of Roche AG and Gilead Sciences's Tamiflu and Glaxo's and Biota's Relenza, antiviral drugs used to treat flu, with 100 million treatment courses to be available in the autumn.

Medicine