Coping with the absences hasn't been has bad as it could be. Roepke has long had a policy of training staffers so they can easily substitute for one another.
"We're dealing with so many deadlines. It's important that anyone can step in and do anything. That has helped us during this time," she says.
Even with such a small staff, Roepke says she'd rather have staffers stay home when they're not feeling well. An employee who was taking part in a meeting with clients from the Netherlands came down with the flu and Roepke knew the staffer would drag herself in despite being so ill. So Roepke e-mailed the staffer's husband.
"I said, 'please help me convince her to stay home,'" Roepke says. The employee agreed, and a co-worker filled in for her.
Companies that provide care for elderly and chronically ill people have to find substitutes when one of their caregivers comes down with the flu. Sometimes, a sub needs to be found immediately.
Four caregivers who work for the Caring Senior Service in Amarillo, Texas, called in sick last week. Owner Bill Archinal does have a pool of workers he can call on because the staffing needs in the caregiving business tend to fluctuate.
One caregiver who got the flu began to get symptoms while she was with a client. That meant finding someone right away to relieve her — no one wanted to risk having her infect her client. So a supervisor went to the client's home.
"When this caregiver called and said, 'I think I'm getting the flu,' they said, 'I'll be right there,'" Archinal says. "We want to get that sick person out of there."
Finding a replacement can become complicated. Sometimes a client will resist having someone they don't know come to care for them.
"They get upset and say, just don't send anybody," Archinal says. If the client is someone who is frail and really needs the help, then supervisors will intervene and try to persuade the client to accept a substitute.
As hard as it is for small businesses with employees to weather the flu, it's even tougher for the more than 21 million companies that have no employees. When the owner is sick and can't work, there's no one to delegate to.
Last week, Ed Zitron was sick and lost his voice. He was able to get much of his work done by e-mail for his one-man public relations business, but phone calls were out of the question.
"I had to cancel calls left, right and center. People who I promised to call had to just not talk to me," says Zitron, whose company, EZPR, is based in New York.
But Zitron's clients were understanding. He attributes that to having developed strong relationships and a sense of trust with them. And he's up-front about not being able to work.
"I tell them the truth ... I just got really sick," he says. "They know I'm a solid person. They know I'm not going to disappear with their money."