Meanwhile, Duke University said Thursday that about 84 adults who had been attending a basketball camp on campus were being treated for illness after likely exposure to the Legionella pneumophilia bacteria, which causes the disease. Concerns over this severe form of pneumonia have spread to Missouri, where state health authorities are advising recent guests of the Quality Inn in Bethany that they risk possible exposure to legionella after a visitor at the hotel had fallen ill with the disease. In July, Michigan noted an alarming spike in Legionnaires’ disease, with 107 cases reported in the first half of the month — a 569 percent increase compared with the same time in 2020. Stay-at-home policies during the pandemic may be contributing to the rise in illness. Legionella bacteria can often flourish in building water systems, according to the Centers for Disease Control and Prevention (CDC), especially when water remains stagnant for an extended period of time. Cooling towers, whirlpool spas, hot tubs, humidifiers, hot water tanks, and evaporative condensers of large air-conditioning systems can all be ideal breeding grounds. “As many buildings are currently reopening after extended COVID-19 closures or periods of limited use, this may create an environment for potential amplification and transmission of legionella bacteria,” wrote the Michigan Department of Health and Human Services. People get the disease by breathing in water vapor that contains the bacteria. The illness, however, is not contagious. The CDC says that number of reported has been on the rise since 2000. The National Academies of Sciences, Engineering, and Medicine (NASEM) estimates that 52,000 to 70,000 Americans develop Legionnaires’ disease annually. Legionnaires’ symptoms are similar to other types of pneumonia and include cough, shortness of breath, fever, muscle aches, and headaches. The disease can be treated with antibiotics when caught early. “Anyone with flu-like symptoms should seek care early and — if they live in the affected area — ensure they are evaluated for Legionnaires’ disease,” said NYC Health Commissioner Dave A. Chokshi, MD, in a statement. “Most people exposed to legionella don’t get sick but there are people at higher risk, such as those 50 and older, especially those who smoke and have chronic lung conditions.”