Listen up, germophobes! What’s icky vs. OK

By Maryn McKenna

updated 8:23 a.m. ET Feb. 19, 2009

At least once a day, Lisa Pisano feels the itch. The 30-year-old fashion publicist goes to the reception desk of her New York City office to accept a delivery of clothing samples from a designer. The courier hands over the garments, swings his messenger bag forward on his hip, fishes inside for a clipboard and hands her a pen. And then she feels it: a tickle at the back of her mind. A little rush of disquiet. Oh, my God, she thinks. Where has that pen been?

She imagines the possibilities: tucked behind the courier’s ear. Clutched by a stranger’s hand, which that day had probably touched a bathroom door or a subway handrail. She thinks about the millions of people in New York, eating, scratching, rubbing their noses, picking up bacteria and then leaving it on that handrail, and then on the person’s hands, and then on the courier’s pen, and then on her hand, her face, her lungs, her… Ick.

Pisano has always been germ-conscious — she wipes off her purse if it’s been resting on the floor and swabs her keyboard, phone and mouse with disinfecting wipes — but the pen problem pushes her over the edge every time.

One day, on the way to work, she spotted her salvation in an office-supply store window: a pen made of antibacterial plastic. She bought a handful and now, whenever the messengers buzz for her, she carries one to the door. Her co-workers tease her. She ignores them. “I’m known in the office for being a little nutty about my pens,” she says, laughing but not apologizing. “If you take my pen, I’m coming after you.”

Admit it: You’ve got something in your own life that makes you go ick. Ask any group of women what they do to protect themselves from germs, and the stories will pour out: We open the bathroom door with elbows, punch the elevator buttons with knuckles, carry wet wipes to disinfect the ATM — and we wonder whether we’re going a little too far. Even the doctors we turn to for reassurance aren’t immune. “I’m extremely aware of the potential for being ‘contaminated,’ in and out of my office,” says Susan Biali, M.D., a 37-year-old physician in Vancouver, British Columbia. “I wouldn’t touch the magazines in the waiting room if you paid me!”

When Self.com polled readers about their germophobia, more than three quarters said they flush public toilets with their foot, and 63 percent avoid handrails on subways, buses and escalators — all unnecessary precautions, experts say. Almost 1 in 10 say they avoid shaking hands, behavior that may flirt with full-fledged obsession, when your efforts to sanitize your life begin to stymie your day-to-day functioning.

Germophobia, of course, is not listed in the Diagnostic and Statistical Manual of Mental Disorders. But mental-health professionals agree that, in vulnerable people, extreme germ awareness can be both a symptom of and a catalyst for a variety of anxiety ailments for which women are already more prone — including obsessive-compulsive disorder, which often features repetitive hand washing and fear of contamination. Ironically, hands that are dry and cracked from overwashing are more likely to pick up an infection through openings in the skin, says Joshua Fox, M.D., a spokesman in New York City for the American Academy of Dermatology.

MSNBC archival video   Americans obsessed with germs? Oct. 22, 2007: Have antibacterial products strengthened germs? MSNBC's Contessa Brewer reports. MSNBC

Even mild germophobia makes you vulnerable to a vast new industry designed to capitalize on your fears and sell you antimicrobial products. But these have proven no better at germ killing than the original products — and may even be bad for your health. “We have now gone so far over the top in our response to germs that in and of itself has become something of a scandal,” says Harley Rotbart, M.D., professor and vice chairman of pediatrics at the University of Colorado Denver School of Medicine and author of “Germ Proof Your Kids” (ASM Press). “We can’t live our lives normally if we are consumed by avoiding germs.”

A germier world
The problem is that — in a time when one outbreak of salmonella can sicken hundreds and staph infections kill more people each year than AIDS — germophobia doesn’t seem so paranoid. On the contrary, it feels like a reasonable reaction to risks we cannot control. Because of population growth, globalization and the movement of most work to the indoors, “we share more space and touch more surfaces that other people have touched than ever before,” says Chuck Gerba, Ph.D., professor of environmental microbiology at the University of Arizona in Tucson, who has spent 35 years tracking germs in public places. More than 300 new infections emerged between 1940 and 2004, according to the journal Nature. Because of record numbers of airplane flights, diseases globe-trot more quickly, and media coverage keeps us more aware of them.

Your queasy-making questions answered Q: Is it true that it’s safe to eat food off the floor as long as it’s been less than five seconds? In 2006, a team of researchers at Clemson University in South Carolina put the five-second rule to the test, dropping bologna and bread onto contaminated wood, tile and carpet to see how quickly the food absorbed salmonella. Turns out the rule is itself a bit of baloney: Although the number of bacteria on the food did increase with time, potentially illness-causing contamination was virtually instantaneous. “If you drop food, the best policy is not to eat it,” says Paul Dawson, Ph.D., professor in Clemson’s department of food science and human nutrition. Q: If I take a sip of someone else’s wine, does the alcohol kill the germs? Unfortunately, no. “It’s the glass that’s more likely to transmit germs than the wine,” notes Harley Rotbart, M.D., a physician in Denver. It’s safest not to share anything that has touched another’s mouth. Still, Dr. Rotbart adds, “for a couple who kiss on the mouth, there is no additional risk to sharing a glass of wine or other mouth-contact items. And don’t stop kissing.” Q: Could smooching my puppy make me sick? When we said don’t stop kissing, this is not what we meant. Although many diseases can’t be passed between species, some — including salmonella and roundworm — can. The American Veterinary Medical Association in Schaumburg, Illinois, warns against putting your mouth on any part of your pet. And wash your hands after handling Fido and his pooper-scooper, as well as his food and bedding, because pets may track germs in from outside. Q: I know I’m supposed to wash my hands. But is it bad, germwise, if I don’t dry them? Germs love moisture and live longer on moist hands. “Part of the benefit achieved by hand washing depends on adequate drying,” Dr. Rotbart says. “Drying physically removes additional germs and takes away the favorable moist growth environment.” Paper towels are better at germ swiping than air dryers. Q: What’s the single germiest surface that  I touch on a daily basis? Surprise: It’s not your toilet seat, says germ tracker Chuck Gerba, Ph.D.: “People make an effort not to touch it with their hands.” Gerba cites home offices, teachers’ desks and kitchen sinks — which, due to contact with raw food, harbor more fecal bacteria than the toilet bowl!

Organisms that can make us sick are everywhere and take every form: They can be bacteria, which are microscopic single-celled organisms such as staph and strep; equally small fungi such as yeast and parasites such as worms; or even smaller viruses, such as hepatitis or flu. We pick them up directly from other people in sweat, saliva, semen and other body fluids; in exhaled breath or skin-to-skin contact; or from contaminated surfaces, food or soil. They enter our body through cuts or abrasions or when we breathe them in, swallow them or transfer them to our mucous membranes by touching our eyes, nose or mouth.

Gerba’s annual sampling routinely turns up disease-causing bacteria on computer keyboards, desks, faucets, picnic tables, purses and more. His 2008 study found three and a half times more bacteria on office computer mice compared with 2005. During cold and flu season, one third of office phones housed cold viruses. The skin infection MRSA (short for methicillin-resistant Staphylococcus aureus) has turned up on the seat-back trays we eat off of on airplanes. And when researchers at the University of Colorado at Boulder studied the microorganisms on college students’ palms, they discovered that women’s hands have significantly more types of bacteria than men’s — even though women reported washing their hands more often. The team isn’t sure why, but one theory is that men’s more acidic skin is less amenable to the bugs, says lead researcher Noah Fierer, Ph.D., assistant professor of ecology and evolutionary biology.

Diane Bates, owner of a marketing and public relations agency in New York City, is more aware of this germ explosion than she ever wished to be. When her twin daughters were 2 years old, they contracted rotavirus, an intestinal infection she believes they caught from an acquaintance whose child had it. Hospitalized for five days, the girls were so sick that Bates couldn’t enter their hospital room without a mask, gown and gloves. “It was very traumatic, and it got me thinking about germs and I started to modify my behavior,” says Bates, 41. Four years later, avoiding germs is almost her household religion: She constantly surfs CDC.gov to check for infectious disease alerts, buys every new air purifier and uses antimicrobial tissues. She doesn’t allow her kids to touch salt shakers in restaurants, skips family gatherings if another child has a cold and scolds her husband when he lets the girls play on jungle gyms. “My friends and family roll their eyes. But I’ll take whatever sarcasm I have to in order to keep my family healthy,” Bates says. “At some point I know it is more phobic than productive, but I feel if I do every single thing I could possibly do, it might make a difference.”

MORE FROM INFECTIOUS DISEASES

Infectious diseases Section Front

Childhood vaccine cost to drop next year Biggest child-killers: pneumonia and diarrhea Shots on horizon for Alzheimer's, AIDS, herpes 9 surprising places where germs lurk Antibiotic overuse could threaten medicine Dutch pull Pfizer vaccine batch after infants die New vaccine offers hope in malaria battle Millions die because of high malaria drug prices Experts: U.S. should take lead to halt outbreaks Plague death: Researcher dies from infection Infectious diseases Section Front   Add Infectious diseases headlines to your news reader: