Leaders Creating Leaders for Tomorrow

HCOP’s Dr. Marilyn Bulloch previews flu season

November 2, 2022

AUBURN, Alabama – Flu season is here, and the consensus among experts is that the season is shaping up to be more severe than in the past few years.

Marilyn Bulloch, associate clinical professor in the Harrison College of Pharmacy’s Department of Pharmacy Practice, provided comments on what is known about this year’s influenza season.

Bulloch received her Doctor of Pharmacy from Rutgers University in 2007 and completed residencies at the University of Alabama at Birmingham and the Charleston (South Carolina) Area Medical Center. Her research interests include acute care pharmacotherapy, infectious diseases, internal medicine and medication use in older adults. She has spoken at the national, regional and local level on a variety of medicine related topics, including influenza and other concerning viral infections. She has been published in numerous medical and pharmacy journals.

Flu season coming on strong

Outbreaks of influenza appear to be particularly strong and contagious this year. Numbers are high and vary across regions, with some schools reporting nearly a third of their students have been out at some point with the flu.

According to Alabama Department of Public Health data, numbers are peaking roughly two months before they did last year and at a higher percentage. Updated numbers are available on dashboards on both websites.

“The flu arrived a lot earlier than it usually does, and many people either had just got their flu shot or had not gotten their flu shot yet,” said Bulloch. “It takes two weeks for your body to make antibodies and provide full protection after the vaccine. Some people got the vaccine, but it might not have been early enough, and they may have been exposed before their bodies were fully protected.”

Impact on flu season

With an early spike in infections, what does that mean for flu season? Experts still do not know.

Influenza begins each year in the southern hemisphere and makes its appearance in the northern hemisphere in the fall, running through the spring. There are also multiple strains, typically called Influenza A and Influenza B, and their smaller categories.

“Getting infected with one strain does not provide you immunity from the other strains,” said Bulloch. “In the seasons before the COVID-19 pandemic, we saw more than one flu season where one type of flu virus would dominate in the fall/early winter and then in the New Year, a different type of influenza would circulate. It was not uncommon for people, mainly those who were unvaccinated, to get the flu twice in the same flu season.”

Vaccine and treatments

While the Centers for Disease Control and Prevention tracks vaccine effectiveness, it is still too early to get a full reading of the effectiveness of this year’s version. Even with that, the vaccine is strongly encouraged, as while some vaccinated people have been infected with the flu, their symptoms have shown to be significantly milder than those of unvaccinated.

“I think it is also important to remember that the flu vaccine protects you against multiple types of the flu,” said Bulloch. “Even if someone has already had the flu recently, they should get the flu shot to protect them from other strains of the flu that could circulate later in the season, to help them avoid getting the flu again this year.”

If you get the flu, you should stay home until you are symptom- and fever-free without medications for at least 24 to 48 hours. There are medications that can help to treat the flu, including Tamiflu and a newer, one-dose medication called Xofluza.

“If your child is prescribed liquid Tamiflu, ask the pharmacy to flavor the medication to make it taste better, as they often do not like the original flavor,” said Bulloch. “One of the most important things is for people to drink fluids and stay hydrated.”


The influenza virus seen this year has many of the common symptoms, including body aches, headache, sore throat, fever and a dry, non-productive cough. Additionally, it appears that those who have had a flu shot have milder symptoms, a much lower fever and appear to get better sooner than those who are unvaccinated.

Do not be afraid to mask

While masking was not common practice in the United States prior to the COVID-19 pandemic, data shows widespread masking and social distancing did have a significant impact on the spread of influenza during that time. The flu never went away, it was just suppressed by measures against COVID-19.

“Regardless of the discussion about masks and COVID-19, we have data that goes back well before 2020 that showed us that masks decrease the spread of influenza,” said Bulloch. “Wearing masks absolutely helped decrease transmission of influenza in the past few flu seasons.”

Bulloch also points out that respiratory viruses tend to circulate and dominate in a population at a given time. Multiple viruses do circulate at the same time and patients can become infected with multiple viruses at one time, but many times one rises to the top and dominates.

“If you look at trends in history, there does tend to be a dominant circulating virus in a season,” said Bulloch. “With COVID-19 cases down, there is an open opportunity for influenza to circulate more easily through the population.”


About the Harrison College of Pharmacy

Auburn University’s Harrison College of Pharmacy is ranked among the top 25 percent of all pharmacy programs in the United States, according to U.S. News & World Report. Fully accredited by the Accreditation Council for Pharmacy Education (ACPE), the College offers doctoral degrees in pharmacy (Pharm.D.) and pharmaceutical sciences (Ph.D.) while also offering a master’s in pharmaceutical sciences. The College's commitment to world-class scholarship and interdisciplinary research speaks to Auburn's overarching Carnegie R1 designation that places Auburn among the top 100 doctoral research universities in the nation. For more information about the College, please call 334.844.8348 or visit http://pharmacy.auburn.edu.

Making Medications Work Through Innovative Research, Education and Patient Care

Last Updated: November 02, 2022