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The idea for the Screamer was for him to lurk in different areas, much like the Witch, paying no attention to his surroundings until coming in contact with a Survivor whereupon, if sufficiently agitated, he would run away from Survivors in an attempt to hide.
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Screamers were presented in-game as Infected humans bound in a restraining psychiatric-style straitjacket. As such, he is the progenitor of Special Infected like the Witch and Boomer. The Screamer was a prototype for Special Infected formulated early in Left 4 Dead 's development.