"I was actually quite pleased," said Nakaji. "As neurosurgeons, we see a lot of bad things and have to deliver a lot of bad news."
Unfortunately, it is difficult to avoid the worm, which usually only infects pigs. Nakaji said Alvarez's hygiene habits were probably not to blame. It was more likely that someone, somewhere, had served her food tainted with the feces of a person infected with the pork tapeworm parasite.
Parasitologists say that while brushes with the pork tapeworms remain relatively rare, they endure in certain areas of the country.
"We've got a lot more of cases of this in the United States now," said Raymond Kuhn, professor of biology and an expert on parasites at Wake Forest University in Winston-Salem, N.C. "Upwards of 20 percent of neurology offices in California have seen it."
And the eggs of the worm are nothing if not resilient.
"These eggs can live for three months in formaldehyde," said Kuhn. "You got to think, sometimes, a person is slapping lettuce on your sandwich with a few extra add-ons there."
"Don't let the bedbugs bite."
What once might have been a facetious nighttime saying became pretty good advice for New York City commuters in 2008, as an official with the city's Department of Housing, Preservation and Development told an audience that the city's subway trains and stations may have been infested with the insects.
The New York City Transit Authority immediately defended itself. But Edward Brownbear, lead education instructor for the housing department and the city's top bedbug authority, reportedly said that he himself had seen the bugs on the wooden benches of Manhattan's Union Square station and The Bronx's Fordham Road station -- as well as on the clothing of a passenger on a train.
At least one Manhattan pest control professional agreed at the time that bedbug infestation had been a growing problem in the city's subway system.
"I've been talking about it for five years," said Jeffrey Eisenberg, president of Pest Away Exterminating, adding that he had personally reported bedbug sightings to subway administrators seven to eight years before.
Efforts to track the critters have revealed that, after a long decline, bedbugs have rebounded in the United States in recent years. This is partly because of increased international travel. The tiny, nocturnal insects are able to live in both fibers and wood. They are also known for their bites, which cause itchy bumps on the skin.
But the bite can lead to more than an itch. According to reports from the U.S. Public Health Service, bedbugs are known to carry dozens of infectious diseases, from smallpox to the flu.
And where people are, the bugs are sure to follow, said Cindy Mannes, spokeswoman for the National Pest Management Association.
"If you think about large groups of people, in many cases this is how bedbugs are transported," Mannes said at the time. "I know they've been found in movie theaters and other strange places."
The horrific nature of a Guinea worm infection is perhaps best captured in its Latin name -- Dracunculus medinensis. Roughly translated, the term means "little dragon of the Mediterranean."