Humans are affected by the HAB species by ingesting improperly harvested shellfish, breathing in aerosolized brevetoxins (i.e. PbTx or Ptychodiscus toxins) and in some cases skin contact. The brevetoxins bind to voltage-gated sodium channels, important structures of cell membranes. Binding results in persistent activation of nerve cells, which interferes with neural transmission leading to health problems. These toxins are created within the unicellular organism, or as a metabolic product. The two major types of brevetoxin compounds have similar but distinct backbone structures. PbTx-2 is the primary intracellular brevetoxin produced by K. brevis blooms. However, over time, the PbTx-2 brevetoxin can be converted to PbTx-3 through metabolic changes. Researchers found that PbTx-2 has been the primary intracellular brevetoxin that converts over time into PbTx-3.
In the U.S., the seafood consumed by humans is tested regularly for toxins by the USDA to ensure safe consumption. Such testing is common in other nations. However, improper harvesting of shellfish can cause paralytic shellfish poisoning and neurotoxic shellfish poisoning in humans. Some symptoms include drowsiness, diarrhea, nausea, loss of motor control, tingling, numbing or aching of extremities, incoherence, and respiratory paralysis. Reports of skin irritation after swimming in the ocean during a HAB are common.
When the HAB cells rupture, they release extracellular brevetoxins into the environment. Some of those stay in the ocean, while other particles get aerosolized. During onshore winds, brevetoxins can become aerosolized by bubble-mediated transport, causing respiratory irritation, bronchoconstriction, coughing, and wheezing, among other symptoms.
It is recommended to avoid contact with wind-blown aerosolized toxin. Some individuals report a decrease in respiratory function after only 1 hour of exposure to a K. brevis red-tide beach and these symptoms may last for days. People with severe or persistent respiratory conditions (such as chronic lung disease or asthma) may experience stronger adverse reactions.
The National Oceanic and Atmospheric Administration's National Ocean Service provides a public conditions report identifying possible respiratory irritation impacts in areas affected by HABs.