First before you go doing anything, please make sure you have all your data backed up. Not your programs, as they may have the virus or worm in them but just the data like you pictures, saved files, documents, videos, music, and other associated user data. In Vista and Windows 7 it's your users folder in the C drive. In XP and prior versions its' your 'document and settings' folder in the c:\Windows folder. However you decide to get your files is up to you, just make sure you back them up as it's a good chance you may loose your data following the information below.
Now before you do a clean install which is usually the best way to ensure you have a clean system, try running the Microsoft Malicious Software Removal Tool
http://www.microsoft.com/security/malwareremove/default.aspx and see if it can't remove the virus or worm you have. Also, run your antivirus program and see if it can't fix your problem. If you don't have one, Microsoft has an excellent one that is completely free called Security Essentials
http://www.microsoft.com/Security_Essentials/. If after doing the above, your computer still has issues or you suspect that the virus or worm is still on the computer, then I would recommend you go ahead and do a clean install.