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A San Diego man was infected with a smallpox-related virus after having sexual contact with someone who had recently been vaccinated, according to a new government report.The new report from the Centers for Disease Control and Prevention revealed that the infected 24-year-old man then passed the virus along to another unvaccinated individual during sexual activity in a process called tertiary transmission.

According to federal health officials, because the vaccine contains a live virus, it can cause symptoms in vaccinated individuals. What's more, the vaccinia virus, or the virus used in the smallpox vaccine, can potentially spread to others.  While the smallpox vaccine does not actually contain the actual smallpox virus and cannot cause smallpox, it is related to the smallpox virus and helps the body develop immunity to small pox.

Others can become infected with the vaccine virus if they touch the vaccination site on an individual who has been vaccinated or if they are exposed to clothing that has been contaminated with the virus. According to the CDC, symptoms associated with the vaccinia virus infection include a rash, a fever and head and body aches.

Since the U.S. Department of Defense resumed smallpox vaccination for designated military personnel, civilian employees, and contractors, there have been 115 reports of vaccinia virus transmission between vaccinated and unvaccinated people, according to a 2011 review.  Federal health officials said that most transmissions of vaccinia virus from people who were vaccinated to unvaccinated individuals occur through intimate contact or contact between a mother and child.  The report notes that tertiary transmission has also been reported among household and sports contacts.

However, the latest case is the first reported instance of tertiary vaccinia transmission through sexual contact, according to the CDC Morbidity and Mortality Weekly Report.

The first man became infected with the virus when he had sex with a man who had recently been vaccinated but failed to keep his vaccination site properly covered. The infected man had gone to a private hospital in San Diego with a painful rash in his anal area and on his lip. The man also experienced fever, fatigue and nausea.  According to the report, the man "recalled feeling moisture on an uncovered area of his partner's left upper arm and was concerned that his rash might have been caused by this exposure".  When the infected man later had sex with a different man, the third individual was also infected and developed a rash on his penis and forearm.

According to the report, doctors treated both infected men with vaccinia immune globulin (infection-fighting antibodies from people who had already been vaccinated against the disease), and both men recovered within a few weeks. 

However, there is a good ending to this story.  Both the unvaccinated men who were infected with the vaccinia virus are now immune to smallpox.

Researchers said that the latest report illustrates the potential for the vaccinia cirus to spread beyond the immediate contacts of a person who has been vaccinated.  Researchers say that the study also highlights the importance following healthcare instructions and properly covering the vaccination site.