Cellphones, IPods, computer keyboards, digital security pads, elevator buttons, BlackBerrys, bank machines and even bank cards.

In our increasingly digitized, interactive world the medium for spreading germs is expanding and creating a whole new generation of techno-germaphobes.

We have seen a flood of germ-fighting products appear on pharmacy and supermarket shelves and a number of famous germaphobes -- such as Howie Mandel, Donald Trump and Jennifer Lopez --come out of the closet.

While a mild fear over contact with objects that could be contaminated with germs is fairly common, some Canadians develop an obsessive compulsive disorder (OCD) that can be debilitating.

Dr. Peggy Richter, a staff psychiatrist at the Centre for Addiction and Mental Health (CAMH) since 1992, sees about 40 to 50 patients per year who have a problematic preoccupation with germs and fear of contamination.

Richter said to reduce their anxiety, many people with a profound fear of germs constantly clean themselves and develop cleaning rituals.

"When this interferes with their ability to function or cause them to waste at least an hour per day then it could be diagnosed as OCD," she said.

Richter said Torontonians have become more aware and cautious of severe infectious illnesses since the SARS scare hit the city.

INCREASED RISKS

And there has been an increase of milder forms of OCD, where people have become preoccupied with getting clean but are not yet in a state of distress or impaired by the problem, she said.

"There are lot more people out there who have slightly exaggerate concerns but for whom it doesn't pose a problem in their everyday life."

Those who are mildly affected might just waste an hour per day or have troublesome thoughts, but for more severe causes of OCD Richter said it can become completely disabling to the point that they are housebound.

"They may not eat, shower or leave their home for months," she said. People who avoid touching doorknobs, shaking hands, using public washrooms and have become preoccupied with germs to the point that it is hard for them to focus on other things are showing some warning signs.

"Some might even fear going out into public places because of contact of with other people even indirectly because of the air they breathe," she said.

The most common problem is excessive handwashing to the point where the skin becomes so dry that it cracks, which makes it easier to get contaminated.

"I've seen people with reddened and whitened hands where the skin is cracking and bleeding," she said. "They're sometimes in significant pain because of this."

New technology is contributing to our fear of germs and there is considerable controversy over the degree to which we should worry about contamination from electronic products, let alone more mundane fears of germs on taps, toilet seats and door handles.

Dr. Chuck Gerba, a microbiologist at the University of Arizona for 27 years, said there are many reasons for people to be fearful since the risk of picking up dangerous bacteria has increased.

Gerba tested public areas such as mall escalators, automated bank machines and first floor elevator buttons and found all showed high concentrations of bacteria.

He also tested cellphones and computer keyboards and found they were more contaminated than a toilet seat or the bottom of a shoe.

"People sharing cellphones might be talking dirtier than they think," he said.

Gerba said cellphones can contain an unhealthy serving of germs that can cause pimples, meningitis and even pneumonia.

The phones he tested were filthy and some showed traits of methicillin-resistant staphylooccus aureus (MRSA) or staph infection. It can cause severe pneumonia, joint and bloodstream infections. MRSA can also cause a rare skin infection that can spread with physical contact and can be deadly.

Hairbrushes are also a popular hiding place for MRSA.

"MRSA killed more people than AIDS last year in the United States," he said. "We saw MRSA in cellphones used by several teenagers who were sharing their phones," said Gerba, who added that MRSA was found in 10% of the phones tested.

He suggests cellphones be kept away from toddlers because they commonly put them in their mouths.

MRSA is responsible for more than 94,000 serious infections and 19,000 deaths each year, U.S. federal health officials told the Washington Post last year.

These deaths are much higher compared to the 12,000 lives claimed by AIDS each year in the U.S., officials said.

Other experts aren't yet convinced our electronic toys and accoutrements are all that dangerous.

Allison McGeer, the director of infection control at Toronto's Mount Sinai Hospital, suggests Gerba is jumping the gun.

McGeer said objects that humans touch sometimes get contaminated but people shouldn't start throwing out their cellphones or become worried because they shared someone's keyboard or touched a mall escalator rail.

"It's true that cellphones can have more germs than a toilet seat," she said. "As long as you don't share you cellphone there shouldn't be any danger because you cellphone is carrying your own germs."

McGeer said the easiest viruses to pick up from the environment are the ones that cause coughs and colds.

She added that people -- not things -- are the most common transmitters of bacteria.

"Your chances of picking things up from stuff that other people have touched and ingesting them are not that great," she said. "They're obviously even lower if you wash your hands."

Viruses like influenza don't survive well on computer keyboards or bank machines because they die fairly quickly after contact.

"To influenza, a computer keyboard is like a desert," she said.

McGeer explains that an infected person would, for example, have to sneeze on their hand right before using a bank machine to contaminate the keypads.

To catch their bug, the next person in line would have to use the machine and then immediately put their fingers into their mouth or nose.

"The real risk is if someone comes up and talks to you," said McGeer, because germs can be more easily spread by a cough, sneeze or hand shake.

She added MRSA is a serious skin infection but the people who need to watch out for it are sports teams with equipment kept in warm bags.

"When you get into a situation where you're sharing wet, sweaty stuff that is stashed away where bacteria can grow, then you get a problem," McGeer said.

Players sometimes shower together and share contaminated bar soaps, which facilitate the growth and transmission of bacteria from one person to the next, she said.

And there have been documented outbreaks of herpes in wrestling teams because they have close skin-to-skin contact.

MARKETING CLEANLINESS

"We worry about catching diseases from people we don't know, but actually the most likely place that I'm going to get an infectious disease by a huge difference is my kids," said McGeer.

Children are less hygienic than adults and they pick up germs from their class and teammates.

McGeer also had a message for people who are drying out their skin by overusing hand sanitizers, thinking they are getting the best results.

"The good old soap and water are still the best thing," she advised.

Finally, Dr. Andrew Simor, a microbiologist at Sunnybrook hospital, suggested a lot of the fear over germs is more about marketing products than public health.

Companies like Apple have recently released the ISkin keyboard protector made from silicone. It is designed to catch oils and dirt that would build up on the keyboard.

Cellphone manufacturers such as Samsung have also put out a cellphone coated with an anti-bacterial, silver nano-particle coating.

And there's been an explosion of household products, from hand sanitizers, bacteria-killing wipes to germ-busting dish soap, all intended to cash in on our fear of germs.