Earthworm Sally spread online as a short viral meme song, shared in TikTok edits and soundboard clips where the joke is Sally's absurd cross-country trip from Florida to California. The song presents Sally carrying diseases from one coast to the other, and that ridiculous premise is what creators quote and remix. Like other goofy meme sounds and the sad meow song, it works as a quick audio punchline rather than a serious track, which is why it keeps appearing in animal videos, travel jokes, and random meme edits long after its first viral run.