Vaccinia of the vulva. A case report.

Is monkeypox a new, emerging sexually transmitted disease? A rapid review of the literature

“…Evidence about vaccine‐strain vaccinia viruses as sexually transmitted pathogens is scarce and anecdotal, with a few cases of genital lesions, including vaginal, vulvar, and, less frequently, perianal vaccinia infections, in women apparently healthy or with underlying conditions (like atopic dermatitis), reporting having sex with male civilian 41–44 or military smallpox vaccinees, 45–51,53 or cases of genital and perianal rash in men having sex with male civilian smallpox vaccinees 52 . It can be hypothesized that “sexual intercourse provides the intimate contact required for heteroinoculation.” 41 Of note, the cases reported in the MSM community include the first described instance of tertiary vaccinia transmission through sexual contact 52 . Interestingly, the secondary vaccinia case reported a history of psoriasis and a possible history of eczema (atopic dermatitis), whilst the tertiary vaccinia case recalled a history of eczema: both exhibited systemic symptoms, requiring hospitalization and vaccinia immune globulin intravenous administration 52…”

“…[41][42][43][44][45][46][47][48][49][50][51][52][53] However, for SARS-CoV-2 evidence related to sexual transmission is particularly ambiguous and contrasting. Evidence about vaccine-strain vaccinia viruses as sexually transmitted pathogens is scarce and anecdotal, with a few cases of genital lesions, including vaginal, vulvar, and, less frequently, perianal vaccinia infections, in women apparently healthy or with underlying conditions (like atopic dermatitis), reporting having sex with male civilian [41][42][43][44] or military smallpox vaccinees, [45][46][47][48][49][50][51]53 or cases of genital and perianal rash in men having sex with male civilian smallpox vaccinees. 52 It can be hypothesized that "sexual intercourse provides the intimate contact required for heteroinoculation."…”

“…52 It can be hypothesized that "sexual intercourse provides the intimate contact required for heteroinoculation." 41 Of note, the cases reported in the MSM community include the first described instance of tertiary vaccinia transmission through sexual contact. 52 Interestingly, the secondary vaccinia case reported a history of psoriasis and a possible history of eczema (atopic dermatitis), whilst the tertiary vaccinia case recalled a history of eczema: both exhibited systemic symptoms, requiring hospitalization and vaccinia immune globulin intravenous administration.…”

“…17,39,40 Besides these viruses, other viral agents could be potentially isolated from semen, including influenza virus, lymphocytic choriomeningitis virus, phlebotomus fever virus, coxsackie B virus, echovirus, dengue virus, "Severe Acute Respiratory Syndrome" (SARS) coronaviruses type 1 (SARS-CoV) and 2 (SARS-CoV-2), rubella virus, Lassa virus, Crimean-Congo hemorrhagic fever virus, and poxviruses (such as smallpox virus, and vaccinia virus). [41][42][43][44][45][46][47][48][49][50][51][52][53] However, for SARS-CoV-2 evidence related to sexual transmission is particularly ambiguous and contrasting. Evidence about vaccine-strain vaccinia viruses as sexually transmitted pathogens is scarce and anecdotal, with a few cases of genital lesions, including vaginal, vulvar, and, less frequently, perianal vaccinia infections, in women apparently healthy or with underlying conditions (like atopic dermatitis), reporting having sex with male civilian [41][42][43][44] or military smallpox vaccinees, [45][46][47][48][49][50][51]53 or cases of genital and perianal rash in men having sex with male civilian smallpox vaccinees.…”

Some Penalties of Promiscuity

“…Occasionally diseases other than those listed above may be transmitted sexually, as for example vaccinia of the vulva (McCann et al 1974). Finally it is unfortunate in the present state of knowledge that contraception does not necessarily provide simultaneous protection against pregnancy and sexually transmitted disease. It is important therefore that gynaecologists instruct their patients to the effect that barrier methods give protection against pregnancy and sexually transmitted disease, but intrauterine contraceptive devices and oral contraceptives against pregnancy only.…”