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updated 1/25/2011 8:34:13 AM ET 2011-01-25T13:34:13

When Adrienne Denaro got married three years ago, there was one wedding gift she could have lived without: the flu.

“My 12-year-old cousin was a junior bridesmaid and went around coughing on people while we were getting ready,” says Denaro, a 32-year-old copywriter from Miami. “She didn’t come across as feverish and sniffling and we didn’t think that her coughs were real. But they were. She had the flu and a week later, my new husband and I were sick as dogs.”

Denaro’s young cousin is an example of what the National Foundation for Infectious Diseases(NFID) would call “that guy.” You know, that person who shows up at work, school, a party or next to you on the bus spewing icky flu germs with little appreciation for the fact they’re infecting everyone around them.

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In fact, 66 percent of Americans admitted to carrying on with their daily routine even though they knew they had early flu symptoms, according to a survey out Tuesday by NFID.

Nearly the same amount – 59 percent – felt annoyed, anxious and frustrated by flu-ridden people who insisted on putting their health at risk.

This finding, which came from a recent phone survey of 1,000 Americans across the country, arrives just as flu kicks into high gear this winter. The Centers for Disease Control and Prevention warns that 17 states have reported widespread flu activity this month. Nearly every other state has seen recent spates of sickness.

CDC map: Is the flu near you?

“We’ve all seen ‘that guy’ out there,” says Dr. Susan Rehm, medical director for the NFID. “It’s the person who’s coughing and sneezing their way down the aisle of the airplane while you’re waiting to take off. Or the sick person in the cubicle next to you who makes you think, ‘Why don’t you just go home?’”

Why do we keep going and going even when we know we should be home in bed?

Dr. William Schaffner, chair of the department of preventive medicine at Vanderbilt University in Nashville, is sympathetic. “A lot of people have social events they don’t want to miss or they feel like they’d be letting people down. For some, if they don’t show up at work, they won’t get paid and they need the paycheck. There are lots of reasons why people want to tough it out.”

The problem is, toughing it out while you’re experiencing a fever, body aches and  a hacking cough means anyone who comes within six feet of you could be in the same place a few days later.

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Story: Most people go to work when sick, survey finds

“My symptoms started last Saturday,” says Mike Harrison, a 45-year-old consulting civil engineer from Sacramento. “Headache, body aches, fatigue, coughing, congestion. But I got called for jury duty and you’ve got to report. So I went in.”

Harrison says he tried to avoid touching people and isolated himself in a cubicle, but Schaffner says that’s often not enough.

Story: Symptom tracker: Cold, flu — or something else?

“It’s not just coughing or sneezing,” he says. “A person with influenza will breathe out the virus — it’s in their respiratory tract — and one or two moments later, someone else will inhale that same air.”

Schaffner says anyone who comes within three or four feet of someone with the flu is at risk of breathing it in. If the person is coughing or sneezing, the area of infection expands to six feet.

And while people with a hearty immune system may be able to suck it up and sally forth, they’re doing so at the expense of others.

“When we get sick, we have to care for ourselves, but also care for others,” says Schaffner. “Those folks who have milder infections can still transmit to others. But they may not get the mild version; they may become seriously ill.”

Confusion between cold and flu symptoms is another reason people will keep a sniffly nose to the grindstone, says Rehm. To combat the confusion, the NFID has come up with a mnemonic device, “Know the F.A.C.T.S.”

“Fever, aches, chills, tiredness and sudden onset are all characteristics of influenza,” she says. “That should trigger people to stay at home, call their doctor and pay close attention. We forget that influenza is a serious illness. Around 200,000 people are hospitalized with it every year; 40,000 die from it.”

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What can you do if you encounter a walking flu factory?

Both experts say vaccination is key, especially as we enter the peak flu month of February (flu season usually runs from November through March). Outside of that, they recommend frequent hand-washing (or hand sanitizing), avoiding anyone with flu symptoms and finally, employing those powers of persuasion.

Survey: Most people go to work when sick

“Encourage the person to go home,” says Schaffner. “You might even ask the boss, ‘Don’t you think Suzy ought to go home? She looks miserable and she’s going to give it to the rest of us.’”

Story: Ah-choo! Cold and flu season ramps up across the U.S.

If all else fails, you could also try shaming the flu offender, suggests Renate Raymond, 39, of Seattle, whose coworkers wrapped her cubicle in clear plastic and caution tape after she went to work with the flu.

“When I came in sick the second day, they’d quarantined me,” she says. “I immediately went home.”

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