This Khan Worm was first created when Rick was refueling his rig at a gas station, and a young woman named Eve approached him and asked for a ride. He assented, but, when she tried to kiss him, he pushed her away and gave her a religious tract instead. She mocked his religion and then offered to tell him a secret. When she leaned in, she grabbed his face and inserted a Khan worm in his ear. While possessing Rick, it murdered his entire family with a hammer. The Khan Worm then possessed a man that worked at Starlight Cannery. The Khan Worm then went postal at the cannery with a hunting rifle and killed six others before its vessel was shot dead by police. The Khan Worm then left the man's body and waited for the hunters to arrive.
Dean Winchester, Sam Winchester, Bobby Singer, Rufus Turner, Samuel Campbell, and Gwen Campbell all went to the cannery to investigate. The Khan Worm then possessed Dean Winchester and killed his cousin Gwen Campbell. It later left Dean's body and infected Samuel. Samuel was later shot dead by Sam after suspecting him of being possessed by the Khan Worm. Rufus and Bobby decide to cut open Samuel's head to see if the Khan Worm is in there. When they begin cutting into Samuel's skull, the Khan worm animates Samuel's dead body and attacks them. During the struggle, Samuel is electrocuted and the worm leaves his body and infects Bobby, who then stabs and kills Rufus while he is possessed. Sam and Dean overpower Bobby and tie him up.
They electrocute him as they question the Khan Worm inside him, and they learn that the worm is a new creation that Eve cooked up to lead them to Sandusky. She has a message for them that the worm relates: "She's pissed, she's here, and it's going to be nothing but pain for you from here on in." Sam and Dean then tape over Bobby's ears and Dean electrocutes him until the worm slithers out of his ear and dies. Bobby managed to survive this procedure.