"That is what we would like to see more people doing, paying people to stay home," says Jennifer Sizemore, spokeswoman for the Clark County Health District in Las Vegas.

But the Flamingo's move is far from the rule in industry. More employers are dropping distinctions between sick leave and other types of paid absence, forcing workers to choose between staying home with a cold or trudging to work to save vacation time.

Studies suggest that productivity losses from working while sick far outweigh the costs of absenteeism, especially in cases of chronic ailments, such as headaches, allergies or depression.

"There's a much greater impact than we thought," says Dr. William Bunn, vice president for health, safety, security and productivity at Navistar International Corp.'s International Truck and Engine Corp.

Keeping employees healthy during the flu season will be harder this year because of the flu-vaccine shortage. Sixty percent of employers polled by the Society for Human Resource Management had planned to offer flu shots, but most programs were canceled because of the shortage.

Shots are considered good prevention. An employee who gets a flu shot has 43 percent fewer sick days and 44 percent fewer doctor visits, according to a 2000 study in the Journal of the American Medical Association.

Health officials worry about employees who come to work while sick and spread the virus. Flu sufferers are contagious for up to seven days after symptoms occur.