You wake up in the morning with that painful scratch in the back of your throat. You can feel the pressure building in your head. And even though you got plenty of sleep, you still feel like you've been hit by a truck.

You're getting sick. Do you tough it out and head to work? Or stay home and spare your co-workers from your germs?

These winter months are the peak of the cold and flu season, and the workplace is a common transmission point for viruses. Here are some things to consider when you're deciding whether to call in sick, courtesy of Dr. Cuyler Caldwell, a family practice physician at Mercy Clinic Edmond Signal Ridge in Edmond, Okla.

How quickly did it start? Some people will try to work through a common cold, but the flu is definitely cause for staying home. So how can you tell the difference? The two ailments share many symptoms, but a cold comes on more insidiously than the flu, typically starting with the gradual onset of a dry cough, runny nose and congestion. The flu is much more abrupt, announcing its arrival with a sudden fever, headache and muscle aches that "hit people like a ton of bricks," Caldwell says. If that sounds like you, it's best to stay home.

Do you have a fever? No, a real fever? The best indication that you're contagious -- meaning you definitely shouldn't head to work and spread your germs around -- is a fever, Caldwell says. But not every notch above 98.6 degrees is cause for alarm, Caldwell says. A true fever is at least 100.4 degrees. Regular colds can sometimes produce fevers, though they’re not as common as with the flu.

Can you keep your droplets to yourself? Say you've taken your temperature and you're fever-free. You're not feeling great, but you're considering toughing it out at work. If you do, remember that the fastest way to spread a cold around the office is through those tiny droplets sent flying by coughing and sneezing. Take proper precautions, Caldwell says: Wash your hands often. Cough or sneeze into the crook of your elbow, not your hands. And use hand sanitizer (and offer some to your co-workers!)

Do you need a doctor? If, however, you've decided to stay home from work, how do you know whether you should call for an appointment with your physician? Caldwell says if you suspect you have the flu, it's best to get into your doctor right away. That's because anti-viral medications to fight the flu, like Tamiflu, work best with the first one to two days after the onset of symptoms.

"They’re not miracle drugs," Caldwell says. "They just shorten the duration that people feel terrible."

And people with certain other medical conditions -- like asthma -- or those who are very young (infants and toddlers) and very old should see their doctors right away if they develop flu-like symptoms, Caldwell says.

When can you go back? You’ve spent an entire, miserable day in bed eating chicken soup and watching Mad Men on Netflix. Is it safe to go back to work the next day? Well, that depends, says Caldwell. The best indicator of your health is still your fever. If you've been without a fever for 24 hours -- and without medication to reduce that fever -- then it's likely you're no longer contagious and can go back to work.

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