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Disagreement exists as to why heat causes symptoms to abate. Varying hypotheses propose that heat overwhelms the nerve endings that signal itch, that heat neutralizes the chemical that causes the inflammation, or that heat triggers a large release of histamine, causing a temporary histamine deficit in the area. Another theory is that the heat denatures the proteins in the bed bug saliva, changing their composition enough so that they no longer trigger the body's defensive mechanisms.

Bed bugs seem to possess all of the necessary prerequisites for being capable of passing diseases from one host to another, but there have been no known cases of bed bugs passing disease from host to host. There are at least twenty-seven known pathogens (some estimates are as high as forty-one) that are capable of living inside a bed bug or on its mouthparts. Extensive testing in laboratory settings concludes that bed bugs are unlikely to pass disease from one person to another. Therefore bed bugs are less dangerous than some more common insects such as the flea.

The salivary fluid injected by bed bugs typically causes the skin to become irritated and inflamed, although individuals can differ in their sensitivity. Anaphylactoid reactions produced by the injection of serum and other nonspecific proteins are observed and there is the possibility that the saliva of the bed bugs may cause anaphylactic shock in a small percentage of people. It is also possible that sustained feeding by bed bugs may lead to anemia. It is also important to watch for and treat any secondary bacterial infection. Systemic poisoning may occur if the bites are numerous.

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