Article
US Government Alerts of Imminent Attacks Against the Healthcare Sector by Trickbot Group
Arete Analysis

Executive Summary
Last week, the Cybersecurity and Infrastructure Security Agency (CISA) in collaboration with the Federal Bureau of Investigation (FBI), and the Department of Health and Human Services (HHS) released the following alert: AA20-302A – Ransomware Activity Targeting the Healthcare and Public Health Sector.
The alert informs that there is credible intelligence of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers associated with the Trickbot and BazarLoader trojans that often leads to ransomware like the Ryuk and Conti ransomware. The alert also mentions the Trickbot Anchor tool set and Anchor DNS tool developed by this group.
News of these attacks against the Healthcare sector are of special concern due to the recent increase of COVID-19 cases in the US and evidence that shows ransomware attacks against the healthcare sector have been associated with persons losing their lives due to services being routed to nearby hospitals and laboratory results not being quickly delivered electronically to the providers.
Arete statistics and Intel from Arete’s Fusion Center and Open-source intelligence (OSINT) shows that this new wave of attacks since October 2020 have a slight change in TTPs and the BazarLoader malware has now been observed in systems compromised with Ryuk.
The Arete incident response (IR) practice has responded to more than ninety (90) Ryuk engagements since 2019 with more than six breach responses engagements just in the month of October 2020.
Based on Intelligence gathered from our DFIR cases, Arete’s Fusion Center had developed countermeasures deployed in the SentinelOne EDR platform to detect these threats and our Managed Detection and Response (MDR) team has been handling detections at our client’s sites.
This article is meant to share with the community Arete’s statistics and our assessment based on breach response engagements.
Statistical Data from Arete’s Metrics
The information listed below is based on Ryuk cases investigated by Arete IR since January 2019. Our IR and Data Analytics practices work together to track key data points for every ransomware engagement. Our IR practice tracks data points on the ransomware variant and collects statis-tics based on handled engagements:
Since 2019, Arete has responded to Ryuk cases in some of the following sectors:
Healthcare: 19 | Professional Service: 28 | Public services: 21 | Manufacturing: 11 | Technology/Engineing/ Telecom: 6 | Critical Infrastructure: 1
Average duration of business downtime: 9.47 days
Average original ransom demand in bitcoin: 125.39 BTC
Average final ransom demand in bitcoin: 72.58 BTC
Average ransom demand paid in US dollars: $621,064.05
Minimum ransom demand paid in US dollars: $10,000.00
Maximum ransom demand paid in US dollars: $5,177,510.78
Remote access is the most common method of intrusion found 39.34% of the times
During the Ryuk dwell time this year, Arete responded to ten (10) Conti ransomware engagements
Ryuk Ransomware Overview
Since August 2018, a Russian-based cybercrime group has been operating a ransomware known as Ryuk (a customized version of Hermes commodity ransomware).
The industry saw a sudden drop of Ryuk, starting around the time that COVID-19 had its major impact in March 2020. This is also around the same time that a very similar, Conti ransomware, began to kick-off, leading many to believe that Conti was merely a rebrand of Ryuk. The data suggests though that it is possible that Conti was a failed rebrand since Arete IR has not been engaged with Conti infected clients since Ryuk attacks started again in October 2020.
Ryuk typically compromises networks through Trickbot, or Emotet then delivering Trickbot. Trickbot has recently been in the news in the cyber industry due to Microsoft’s approval via a court order to engage in disruption efforts of this botnet. With this active disruption campaign, it is possible that the sudden return and up-tick of Ryuk infections is due to the Russian cybercrime group acting in retaliation utilizing their more mature ransomware product, Ryuk, as opposed to the potentially rebranded, Conti, which could still have been in a testing phase. This is based on the sudden stop of Conti and up-rise of Ryuk in line with the disruption efforts from Microsoft.
According to Microsoft, they initially disabled sixty-two (62) of the initially identified sixty-nine (69) Trickbot servers. Almost immediately, fifty-nine (59) new servers were attempted to be added to the Trickbot infrastructure. As of October 20, 2020, fifty-eight (58) of the new servers have also been disabled leaving a total number of eight (8) known active Trickbot servers.
Ryuk Wave Crashing on US Healthcare
Of the more than ninety (90) total Ryuk ransomware engagements that Arete IR has led since May 2019, nineteen (19) of those engagements were for a client in the healthcare industry (23%). Out of the seven (7) engagements of Ryuk ransomware that Arete IR has led since it re-emerged in October 2020, the most recent case is the only client that is in the healthcare industry (14%). This evidence shows it is not typical for Ryuk attacks to be focused primarily on the healthcare industry. This could further backup the theory that the impending Ryuk wave of attacks on the healthcare
industry could be retaliation for Microsoft’s disruption campaign against the Trickbot infrastructure that Ryuk is known for utilizing for initial intrusion.

Recommendations
Install an Endpoint Detection and Response (EDR) solution with the capability to halt detected processes and isolate systems on the network, based on identified conditions
Block: Any known attacker C2s in the firewall; A high number of SMB connection attempts from one system to others in the network over a short period of time
Implement: A system enforced password policy to force users into changing passwords at least every 90 days; Multifactor authentication (MFA) on RDP and VPN access
If not needed, eliminate vulnerable RDP ports exposed to the internet
Perform: Dark web monitoring periodically to verify if data from the organization is available for sell in the black market; Penetration tests • Periodically patch systems and update tools
Monitor: Connections to the network from suspicious locations; Downloadsuploads of files to file sharing services over non-standard hours, not commonly used in the organization, etc; Uploads of files from Domain Controllers to the internet; Network scans from uncommon servers (e.g. RDP server)
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Article
FortiBleed Campaign Remains Active
The FBI and Secret Service recently warned that the FortiBleed credential-harvesting campaign remains an active threat targeting internet-facing Fortinet FortiGate firewalls and secure socket layer (SSL) virtual private network (VPN) gateways. The agencies report that attackers continue to scan internet-exposed Fortinet firewalls using previously obtained credentials. This has reinforced assessments made by other security researchers, who have stated that “FortiBleed should be treated as an active access operation, not as a one-time credential leak.”
What’s Notable and Unique
FortiBleed, active since February 2026, begins with widespread reconnaissance to identify internet-facing FortiGate firewalls and SSL-VPN services. Once potential targets are identified, operators attempt to gain initial access through credential stuffing, password spraying, and dictionary attacks using previously compromised credentials.
Following successful access, the attackers deploy the Go-based FortigateSniffer tool on compromised appliances. The tool leverages native FortiOS diagnostic functionality to passively intercept authentication traffic across 24 protocols, enabling the collection of cleartext credentials and password hashes passing through the device.
Successfully recovered credentials are reused to expand access, including Active Directory enumeration, Kerberos validation, SMB authentication, and network share discovery, enabling threat actors to move deeper into the victim environment.
Reporting indicates that initial access brokers (IABs) leveraging the FortiBleed attack chain have facilitated access for downstream ransomware operations, including the INC Ransom/Lynx and Payload ransomware groups. This aligns with Arete’s observations of ransomware groups, including INC, Qilin, and DragonForce, targeting Fortinet FortiGate and VPN infrastructure as an initial access vector.
Remediation
Organizations should restrict internet-facing FortiGate management interfaces, rotate administrative and VPN credentials, review local and privileged accounts, and enforce MFA for remote access. If a potential compromise is detected, organizations should isolate affected systems, conduct threat hunting to determine the scope and identify compromised accounts and devices, and preserve relevant logs and artifacts. Organizations should also report the incident to appropriate authorities and implement targeted eviction measures based on identified threat actor activity.
Analyst Comments
FortiBleed represents an ongoing access-enablement threat, rather than a one-time credential exposure. The campaign’s ability to harvest, validate, and reuse credentials can provide sustained access to victim environments and create opportunities for downstream ransomware activity. Organizations with suspected FortiGate exposure should treat the activity as a potential active compromise and investigate for persistent access, compromised accounts, and lateral movement.
Sources
FortiBleed Operations Continue Targeting Exposed Systems Leading to Reports of Lockouts
FBI Warns FortiBleed Remains Active After Amassing 86,644 Fortinet Device Credentials
Article
Threat Actors Exploiting Critical FortiMail Zero-Day Vulnerability
Fortinet has disclosed a critical vulnerability in FortiMail, tracked as CVE-2026-104286, that is currently being exploited as a zero-day in the wild. The flaw, which carries a Critical CVSS score of 9.8, affects the FortiMail management interface and can allow unauthenticated attackers to write arbitrary files to affected systems, potentially leading to unauthorized code execution and full system compromise. Fortinet has confirmed active exploitation and urged customers to implement mitigations immediately while awaiting security updates.
What’s Notable and Unique
The vulnerability stems from improper restriction of file paths combined with improper neutralization of NULL byte characters. An unauthenticated attacker can exploit the flaw via specially crafted HTTP or HTTPS requests to write arbitrary files on the underlying operating system.
Organizations running FortiMail 7.2 can remediate the vulnerability by upgrading to 7.4 or newer. For customers using affected FortiMail 7.4, 7.6, and 8.0 versions, fixes have not yet been released. However, Fortinet has confirmed that the issue will be addressed in the upcoming 7.4.9, 7.6.7, and 8.0.2 releases.
Until the patched versions become available, Fortinet recommends mitigating risk by disabling the Identity-Based Encryption (IBE) feature. As an additional safeguard, administrators should restrict access to the FortiMail management interface, either by removing internet exposure altogether or limiting access to trusted internal networks only. The advisory also includes log entries that administrators can use to identify potentially compromised appliances.
The U.S. Cybersecurity and Infrastructure Security Agency (CISA) has added CVE-2026-104286 to its Known Exploited Vulnerabilities (KEV) catalog and directed federal agencies to perform forensic triage and mitigation by October 4th.
Analyst Comments
Impacted organizations should review their FortiMail instances to ensure there are no unauthorized logins, examine device settings, evaluate all configurations as potentially compromised, and carry out the necessary recovery procedures. Defenders should immediately implement Fortinet's recommended mitigations, review systems for IOC matches, and prepare to deploy the forthcoming security updates as soon as they become available. It is strongly advised that all enterprises assess their setups to reduce risk, as protecting publicly accessible management interfaces is a fundamental security best practice.
Sources
Improper limitation of a pathname to a restricted directory
Article
Ransomware Trends & Data Insights: September 2026
The Akira ransomware group re-emerged as the most active ransomware threat observed by Arete in September. Overall activity remained relatively distributed among multiple threat groups, with 29 unique groups observed throughout the month. Alongside Akira, INC Ransom and the relatively new Storm group were among the three most active threat actors observed in September. Several new threat groups also emerged during the month, including Hades Team, Shiba, and Vortex (which is suspected to be part of the cluster of threat actors affiliated with the former BlackFile group).

Throughout the month, analysts at Arete identified several trends behind the threat actors perpetrating cybercrime activities:
In September 2026, the ShinyHunters threat group escalated its extortion activity by publicly targeting both the Clop ransomware group and the FBI. The group claimed to have breached and defaced Clop’s infrastructure, demanding an eight-figure ransom, while separately alleging the theft of sensitive FBI-related data and demanding the retraction of statements made in a prior public advisory. In both incidents, ShinyHunters employed similar pressure tactics, including website defacements, repeated public postings, and threats of data disclosure.
ClickFix attacks remained prevalent in September 2026, with ransomware groups including Qilin, Helix, and The Gentlemen leveraging ClickFix lures to facilitate PowerShell-based payload execution and initial access. The technique continues to evolve, combining social engineering with legitimate tools and services to enable compromise and evade detection.
September 2026 saw continued activity from the former BlackFile extortion ecosystem. BlackFile, a data theft and extortion operation active since at least October 2025, rebranded as Redact in May 2026, and since appears to have broken off into several affiliated brands, including Pink, Helix, Falcon, Cinder, and potentially Vortex. During September, some affiliates publicly disputed these associations and claimed to operate independently. However, the coordinated timing, messaging, and near-identical nature of these statements support the assessment that these groups remain part of a broader interconnected ecosystem operating under shared objectives or coordination.
Article
Attack Patterns in Settra Incidents
Recent Settra ransomware incidents demonstrate a consistent operational pattern involving compromised credentials, VPN access, and the deployment of ransomware executables tailored to victim environments. Researchers have observed Settra naming ransomware executables after the targeted organization's domain while following similar attack sequences across multiple intrusions. Arete has also identified overlapping tactics, techniques, and tools in Settra engagements observed from June to August, including the use of MeshAgent for remote access and Bring Your Own Vulnerable Driver (BYOVD) techniques to weaken endpoint security controls.
What’s Notable and Unique
Settra operators have been observed naming ransomware executables after the victim organization's domain, creating a direct association between the payload and the targeted environment.
Initial access vectors have included targeting exposed VPN infrastructure and the use of compromised credentials, reducing the need for traditional exploitation of vulnerabilities.
Arete observed MeshAgent in multiple Settra engagements, which provides threat actors with a mechanism for remote access and continued activity within compromised environments.
Settra engagements have also included Bring Your Own Vulnerable Driver (BYOVD) activity, which can be used to bypass or impair security controls by abusing legitimate but vulnerable drivers.
Analyst Comments
Recent Settra activity demonstrates how ransomware operators can combine credential-based access, remote management tooling, and security control evasion techniques to establish and maintain access before ransomware deployment. The repeated use of similar tools and operational patterns across incidents provides useful detection opportunities for defenders. Organizations should closely monitor VPN authentication activity, unusual use of compromised credentials, unexpected MeshAgent deployment, ransomware executables with victim-specific naming conventions, and suspicious driver activity associated with attempts to disable or bypass endpoint security controls.
Arete’s MDR practice detects Settra’s full attack chain, with special attention to the staging of BYOVD activity for defense evasion. However, for us to detect it, SentinelOne needs to be fully deployed across an environment. To support organizations with full deployment, Arete offers SentinelOne Deployment Assistance. This service is designed to ensure that SentinelOne is deployed across all eligible endpoints, eliminating coverage gaps that could otherwise expose the organization to ransomware, malware, credential theft, and other advanced threats. Through endpoint discovery, inventory reconciliation, and deployment assistance, Arete helps organizations achieve comprehensive protection and maximize the effectiveness of their SentinelOne investment. Contact clientcares@areteir.com to learn more.
Sources
Ready, Settra, Go: New Settra Ransomware Variant Deploys MeshAgent RMM



