April 5, 2023

Understanding Qakbot Infections and Attack Paths

Explore the network-based analysis of Qakbot infections with Darktrace. Learn about the various attack paths used by cybercriminals and Darktrace's response.

Written by

Sam Lister

Specialist Security Researcher

Written by

Connor Mooney

SOC Analyst

Inside the SOC

Darktrace cyber analysts are world-class experts in threat intelligence, threat hunting and incident response, and provide 24/7 SOC support to thousands of Darktrace customers around the globe. Inside the SOC is exclusively authored by these experts, providing analysis of cyber incidents and threat trends, based on real-world experience in the field.

Written by

Sam Lister

Specialist Security Researcher

Written by

Connor Mooney

SOC Analyst

Apr 2023

Security vendors around the world are forced to quickly adapt, react, and respond to known attack vectors and threats. In the face of this, malicious actors are constantly looking for novel ways to gain access to networks. Whether that’s through new exploitations of network vulnerabilities or new delivery methods, attackers and their methods are continually evolving. Although it is valuable for organizations to leverage threat intelligence to keep abreast of known threats to their networks, intelligence alone is not enough to defend against increasingly versatile attackers. Having an autonomous decision maker able to detect and respond to emerging threats, even those employing novel or unknown techniques, is paramount to defend against network compromise.

At the end of January 2023, threat actors began to abuse OneNote attachments to deliver the malware strain, Qakbot, onto users' devices. Widespread adoption of this novel delivery method resulted in a surge in Qakbot infections across Darktrace's customer base between the end of January 2023 and the end of February 2023. Using its Self-Learning AI, Darktrace was able to uncover and respond to these so-called ‘QakNote’ infections as the new trend emerged. Darktrace detected and responded to the threat at multiple stages of the kill chain, preventing damaging and widespread compromise to customer networks.

Qakbot and The Recent Weaponization of OneNote

Qakbot first appeared in 2007 as a banking trojan designed to steal sensitive data such as banking credentials. Since then, Qakbot has evolved into a highly modular, multi-purpose tool, with backdoor, payload delivery, reconnaissance, lateral movement, and data exfiltration capabilities. Although Qakbot's primary delivery method has always been email-based, threat actors have been known to modify their email-based delivery methods of Qakbot in the face of changing circumstances. In the first half of 2022, Microsoft started rolling out versions of Office which block XL4 and VBA macros by default [1]/[2]/[3]. Prior to this change, Qakbot email campaigns typically consisted in the spreading of deceitful emails with Office attachments containing malicious macros. In the face of Microsoft's default blocking of macros, threat actors appeared to cease delivering Qakbot via Office attachments, and shifted to primarily using HTML attachments, through a method known as 'HTML smuggling' [4]/[5]. After the public disclosure [6] of the Follina vulnerability (CVE-2022-30190) in Microsoft Support Diagnostic Tool (MSDT) in May 2022, Qakbot actors were seen capitalizing on the vulnerability to facilitate their email-based delivery of Qakbot payloads [7]/[8]/[9].

Given the inclination of Qakbot actors to adapt their email-based delivery methods, it is no surprise that they were quick to capitalize on the novel OneNote-based delivery method which emerged in December 2022. Since December 2022, threat actors have been seen using OneNote attachments to deliver a variety of malware strains, ranging from Formbook [10] to AsynRAT [11] to Emotet [12]. The abuse of OneNote documents to deliver malware is made possible by the fact that OneNote allows for the embedding of executable file types such as HTA files, CMD files, and BAT files. At the end of January 2023, actors started to leverage OneNote attachments to deliver Qakbot [13]/[14]. The adoption of this novel delivery method by Qakbot actors resulted in a surge in Qakbot infections in the wider threat landscape and across the Darktrace customer base.

Observed Activity Chains

Between January 31 and February 24, 2023, Darktrace observed variations of the following pattern of activity across its customer base:

1. User's device contacts OneNote-related endpoint

2. User's device makes an external GET request with an empty Host header, a target URI whose final segment consists in 5 or 6 digits followed by '.dat', and a User-Agent header referencing either cURL or PowerShell. The GET request is responded to with a DLL file

3. User's device makes SSL connections over ports 443 and 2222 to unusual external endpoints, and makes TCP connections over port 65400 to 23.111.114[.]52

4. User's device makes SSL connections over port 443 to an external host named 'bonsars[.]com' (IP: 194.165.16[.]56) and TCP connections over port 443 to 78.31.67[.]7

5. User’s device makes call to Endpoint Mapper service on internal systems and then connects to the Service Control Manager (SCM)

6. User's device uploads files with algorithmically generated names and ‘.dll’ or ‘.dll.cfg’ file extensions to SMB shares on internal systems

7. User's device makes Service Control requests to the systems to which it uploaded ‘.dll’ and ‘.dll.cfg’ files

Further investigation of these chains of activity revealed that they were parts of Qakbot infections initiated via interactions with malicious OneNote attachments.

Figure 1: Steps of observed QakNote infections.

Delivery Phase

Users' interactions with malicious OneNote attachments, which were evidenced by devices' HTTPS connections to OneNote-related endpoints, such as 'www.onenote[.]com', 'contentsync.onenote[.]com', and 'learningtools.onenote[.]com', resulted in the retrieval of Qakbot DLLs from unusual, external endpoints. In some cases, the user's interaction with the malicious OneNote attachment caused their device to fetch a Qakbot DLL using cURL, whereas, in other cases, it caused their device to download a Qakbot DLL using PowerShell. These different outcomes reflected variations in the contents of the executable files embedded within the weaponized OneNote attachments. In addition to having cURL and PowerShell User-Agent headers, the HTTP requests triggered by interaction with these OneNote attachments had other distinctive features, such as empty host headers and target URIs whose last segment consists in 5 or 6 digits followed by '.dat'.

Figure 2: Model breach highlighting a user’s device making a HTTP GET request to 198.44.140[.]78 with a PowerShell User-Agent header and the target URI ‘/210/184/187737.dat’.

Figure 3: Model breach highlighting a user’s device making a HTTP GET request to 103.214.71[.]45 with a cURL User-Agent header and the target URI ‘/70802.dat’.

Figure 4: Event Log showing a user’s device making a GET request with a cURL User-Agent header to 185.231.205[.]246 after making an SSL connection to contentsync.onenote[.]com.

Figure 5: Event Log showing a user’s device making a GET request with a cURL User-Agent header to 185.231.205[.]246 after making an SSL connection to www.onenote[.]com.

Command and Control Phase

After fetching Qakbot DLLs, users’ devices were observed making numerous SSL connections over ports 443 and 2222 to highly unusual, external endpoints, as well as large volumes of TCP connections over port 65400 to 23.111.114[.]52. These connections represented Qakbot-infected devices communicating with command and control (C2) infrastructure. Qakbot-infected devices were also seen making intermittent connections to legitimate endpoints, such as 'xfinity[.]com', 'yahoo[.]com', 'verisign[.]com', 'oracle[.]com', and 'broadcom[.]com', likely due to Qakbot making connectivity checks.

Figure 6: Event Log showing a user’s device contacting Qakbot C2 infrastructure and making connectivity checks to legitimate domains.

Figure 7: Event Log showing a user’s device contacting Qakbot C2 infrastructure and making connectivity checks to legitimate domains.

Cobalt Strike and VNC Phase

After Qakbot-infected devices established communication with C2 servers, they were observed making SSL connections to the external endpoint, bonsars[.]com, and TCP connections to the external endpoint, 78.31.67[.]7. The SSL connections to bonsars[.]com were C2 connections from Cobalt Strike Beacon, and the TCP connections to 78.31.67[.]7 were C2 connections from Qakbot’s Virtual Network Computing (VNC) module [15]/[16]. The occurrence of these connections indicate that actors leveraged Qakbot infections to drop Cobalt Strike Beacon along with a VNC payload onto infected systems. The deployment of Cobalt Strike and VNC likely provided actors with ‘hands-on-keyboard’ access to the Qakbot-infected systems.

Figure 8: Advanced Search logs showing a user’s device contacting OneNote endpoints, fetching a Qakbot DLL over HTTP, making SSL connections to Qakbot infrastructure and connectivity checks to legitimate domains, and then making SSL connections to the Cobalt Strike endpoint, bonsars[.]com.

Figure 9: Event Log showing a user’s device contacting the Cobalt Strike C2 endpoint, bonsars[.]com, and the VNC C2 endpoint, 78.31.67[.]7, whilst simultaneously contacting the Qakbot C2 endpoint, 47.32.78[.]150.

Lateral Movement Phase

After dropping Cobalt Strike Beacon and a VNC module onto Qakbot-infected systems, actors leveraged their strengthened foothold to connect to the Service Control Manager (SCM) on internal systems in preparation for lateral movement. Before connecting to the SCM, infected systems were seen making calls to the Endpoint Mapper service, likely to identify exposed Microsoft Remote Procedure Call (MSRPC) services on internal systems. The MSRPC service, Service Control Manager (SCM), is known to be abused by Cobalt Strike to create and start services on remote systems. Connections to this service were evidenced by OpenSCManager2 (Opnum: 0x40) and OpenSCManagerW (Opnum: 0xf) calls to the svcctl RPC interface.

Figure 10: Advanced Search logs showing a user’s device contacting the Endpoint Mapper and Service Control Manager (SCM) services on internal systems.

After connecting to the SCM on internal systems, infected devices were seen using SMB to distribute files with ‘.dll’ and ‘.dll.cfg’ extensions to SMB shares. These uploads were followed by CreateWowService (Opnum: 0x3c) calls to the svcctl interface, likely intended to execute the uploaded payloads. The naming conventions of the uploaded files indicate that they were Qakbot payloads.

Figure 11: Advanced Search logs showing a user’s device making Service Control DCE-RPC requests to internal systems after uploading ‘.dll’ and ‘.dll.cfg’ files to them over SMB.

Fortunately, none of the observed QakNote infections escalated further than this. If these infections had escalated, it is likely that they would have resulted in the widespread detonation of additional malicious payloads, such as ransomware.

Darktrace Coverage of QakNote Activity

Figure 1 shows the steps involved in the QakNote infections observed across Darktrace’s customer base. How far attackers got along this chain was in part determined by the following three factors:

Whether the targeted customer had Darktrace/Email
Whether the targeted customer had Darktrace RESPOND/Network
Whether the targeted customer acted in response to Darktrace DETECT/Network alerts

The presence of Darktrace/Email typically stopped QakNote infections from moving past the initial infection stage. The presence of RESPOND/Network significantly slowed down observed activity chains, however, infections left unattended and not mitigated by the security teams were able to progress further along the attack chain.

Darktrace observed varying properties in the QakNote emails detected across the customer base. OneNote attachments were typically detected as either ‘application/octet-stream’ files or as ‘application/x-tar’ files. In some cases, the weaponized OneNote attachment embedded a malicious file, whereas in other cases, the OneNote file embedded a malicious link (typically a ‘.png’ or ‘.gif’ link) instead. In all cases Darktrace observed, QakNote emails used subject lines starting with ‘RE’ or ‘FW’ to manipulating their recipients into thinking that such emails were part of an existing email chain/thread. In some cases, emails impersonated users known to their recipients by including the names of such users in their header-from personal names. In many cases, QakNote emails appear to have originated from likely hijacked email accounts. These are highly successful methods of social engineering often employed by threat actors to exploit a user’s trust in known contacts or services, convincing them to open malicious emails and making it harder for security tools to detect.

The fact that observed QakNote emails used the fake-reply method, were sent from unknown email accounts, and contained attachments with unusual MIME types, caused such emails to breach the following Darktrace/Email models:

Association / Unknown Sender
Attachment / Unknown File
Attachment / Unsolicited Attachment
Attachment / Highly Unusual Mime
Attachment / Unsolicited Anomalous Mime
Attachment / Unusual Mime for Organisation
Unusual / Fake Reply
Unusual / Unusual Header TLD
Unusual / Fake Reply + Unknown Sender
Unusual / Unusual Connection from Unknown
Unusual / Off Topic

QakNote emails impersonating known users also breached the following DETECT & RESPOND/Email models:

Unusual / Unrelated Personal Name Address
Spoof / Basic Known Entity Similarities
Spoof / Internal User Similarities
Spoof / External User Similarities
Spoof / Internal User Similarities + Unrelated Personal Name Address
Spoof / External User Similarities + Unrelated Personal Name Address
Spoof / Internal User Similarities + Unknown File
Spoof / External User Similarities + Fake Reply
Spoof / Possible User Spoof from New Address - Enhanced Internal Similarities
Spoof / Whale

The actions taken by Darktrace on the observed emails is ultimately determined by Darktrace/Email models are breached. Those emails which did not breach Spoofing models (due to lack of impersonation indicators) received the ‘Convert Attachment’ action. This action converts suspicious attachments into neutralized PDFs, in this case successfully unweaponizing the malicious OneNote attachments. QakNote emails which did breach Spoofing models (due to the presence of impersonation indicators) received the strongest possible action, ‘Hold Message’. This action prevents suspicious emails from reaching the recipients’ mailbox.

Figure 12: Email log showing a malicious OneNote email (without impersonation indicators) which received a 87% anomaly score, a ‘Move to junk’ action, and a ‘Convert attachment’ actions from Darktrace/Email.

Figure 13: Email log showing a malicious OneNote email (with impersonation indicators) which received an anomaly score of 100% and a ‘Hold message’ action from Darktrace/Email.

Figure 14: Email log showing a malicious OneNote email (with impersonation indicators) which received an anomaly score of 100% and a ‘Hold message’ action from Darktrace/Email.

If threat actors managed to get past the first stage of the QakNote kill chain, likely due to the absence of appropriate email security tools, the execution of the subsequent steps resulted in strong intervention from Darktrace/Network.

Interactions with malicious OneNote attachments caused their devices to fetch a Qakbot DLL from a remote server via HTTP GET requests with an empty Host header and either a cURL or PowerShell User-Agent header. These unusual HTTP behaviors caused the following Darktrace/Network models to breach:

Device / New User Agent
Device / New PowerShell User Agent
Device / New User Agent and New IP
Anomalous Connection / New User Agent to IP Without Hostname
Anomalous Connection / Powershell to Rare External
Anomalous File / Numeric File Download
Anomalous File / EXE from Rare External Location
Anomalous File / New User Agent Followed By Numeric File Download

For customers with RESPOND/Network active, these breaches resulted in the following autonomous actions:

Enforce group pattern of life for 30 minutes
Enforce group pattern of life for 2 hours
Block connections to relevant external endpoints over relevant ports for 2 hours
Block all outgoing traffic for 10 minutes

Figure 15: Event Log showing a user’s device receiving Darktrace RESPOND/Network actions after downloading a Qakbot DLL.

Figure 16: Event Log showing a user’s device receiving Darktrace RESPOND/Network actions after downloading a Qakbot DLL.

Successful, uninterrupted downloads of Qakbot DLLs resulted in connections to Qakbot C2 servers, and subsequently to Cobalt Strike and VNC C2 connections. These C2 activities resulted in breaches of the following DETECT/Network models:

Compromise / Suspicious TLS Beaconing To Rare External
Compromise / Large Number of Suspicious Successful Connections
Compromise / Large Number of Suspicious Failed Connections
Compromise / Sustained SSL or HTTP Increase
Compromise / Sustained TCP Beaconing Activity To Rare Endpoint
Compromise / Beaconing Activity To External Rare
Compromise / Slow Beaconing Activity To External Rare
Anomalous Connection / Multiple Connections to New External TCP Port
Anomalous Connection / Multiple Failed Connections to Rare Endpoint
Device / Initial Breach Chain Compromise

For customers with RESPOND/Network active, these breaches caused RESPOND to autonomously perform the following actions:

Block connections to relevant external endpoints over relevant ports for 1 hour

Figure 17: Event Log showing a user’s device receiving RESPOND/Network actions after contacting the Qakbot C2 endpoint, Cobalt Strike C2 endpoint, bonsars[.]com.

In cases where C2 connections were allowed to continue, actors attempted to move laterally through usage of SMB and Service Control Manager. This lateral movement activity caused the following DETECT/Network models to breach:

Device / Possible SMB/NTLM Reconnaissance
Anomalous Connection / New or Uncommon Service Control

For customers with RESPOND/Network enabled, these breaches caused RESPOND to autonomously perform the following actions:

Block connections to relevant internal endpoints over port 445 for 1 hour

Figure 18: Event Log shows a user’s device receiving RESPOND/Network actions after contacting the Qakbot C2 endpoint, 5.75.205[.]43, and distributing ‘.dll’ and ‘.dll.cfg’ files internally.

The QakNote infections observed across Darktrace’s customer base involved several steps, each of which elicited alerts and autonomous preventative actions from Darktrace. By autonomously investigating the alerts from DETECT, Darktrace’s Cyber AI Analyst was able to connect the distinct steps of observed QakNote infections into single incidents. It then produced incident logs to present in-depth details of the activity it uncovered, provide full visibility for customer security teams.

Figure 19: AI Analyst incident entry showing the steps of a QakNote infection which AI Analyst connected following its autonomous investigations.

Conclusion

Faced with the emerging threat of QakNote infections, Darktrace demonstrated its ability to autonomously detect and respond to arising threats in a constantly evolving threat landscape. The attack chains which Darktrace observed across its customer base involved the delivery of Qakbot via malicious OneNote attachments, the usage of ports 65400 and 2222 for Qakbot C2 communication, the usage of Cobalt Strike Beacon and VNC for ‘hands-on-keyboard’ activity, and the usage of SMB and Service Control Manager for lateral movement.

Despite the novelty of the OneNote-based delivery method, Darktrace was able to identify QakNote infections across its customer base at various stages of the kill chain, using its autonomous anomaly-based detection to identify unusual activity or deviations from expected behavior. When active, Darktrace/Email neutralized malicious QakNote attachments sent to employees. In cases where Darktrace/Email was not active, Darktrace/Network detected and slowed down the unusual network activities which inevitably ensued from Qakbot infections. Ultimately, this intervention from Darktrace’s products prevented infections from leading to further harmful activity, such as data exfiltration and the detonation of ransomware.

Darktrace is able to offer customers an unparalleled level of network security by combining both Darktrace/Network and Darktrace/Email, safeguarding both their email and network environments. With its suite of products, including DETECT and RESPOND, Darktrace can autonomously uncover threats to customer networks and instantaneously intervene to prevent suspicious activity leading to damaging compromises.

Appendices

MITRE ATT&CK Mapping

Initial Access:

T1566.001 – Phishing: Spearphishing Attachment

Execution:

T1204.001 – User Execution: Malicious Link

T1204.002 – User Execution: Malicious File

T1569.002 – System Services: Service Execution

Lateral Movement:

T1021.002 – Remote Services: SMB/Windows Admin Shares

Command and Control:‍

T1573.002 – Encrypted Channel : Asymmetric Cryptography

T1571 – Non-Standard Port

T1105 – Ingress Tool Transfer

T1095 – Non-Application Layer Protocol

T1219 – Remote Access Software

List of IOCs

IP Addresses and/or Domain Names:

- 103.214.71[.]45 - Qakbot download infrastructure

- 141.164.35[.]94 - Qakbot download infrastructure

- 95.179.215[.]225 - Qakbot download infrastructure

- 128.254.207[.]55 - Qakbot download infrastructure

- 141.164.35[.]94 - Qakbot download infrastructure

- 172.96.137[.]149 - Qakbot download infrastructure

- 185.231.205[.]246 - Qakbot download infrastructure

- 216.128.146[.]67 - Qakbot download infrastructure

- 45.155.37[.]170 - Qakbot download infrastructure

- 85.239.41[.]55 - Qakbot download infrastructure

- 45.67.35[.]108 - Qakbot download infrastructure

- 77.83.199[.]12 - Qakbot download infrastructure

- 45.77.63[.]210 - Qakbot download infrastructure

- 198.44.140[.]78 - Qakbot download infrastructure

- 47.32.78[.]150 - Qakbot C2 infrastructure

- 197.204.13[.]52 - Qakbot C2 infrastructure

- 68.108.122[.]180 - Qakbot C2 infrastructure

- 2.50.48[.]213 - Qakbot C2 infrastructure

- 66.180.227[.]60 - Qakbot C2 infrastructure

- 190.206.75[.]58 - Qakbot C2 infrastructure

- 109.150.179[.]236 - Qakbot C2 infrastructure

- 86.202.48[.]142 - Qakbot C2 infrastructure

- 143.159.167[.]159 - Qakbot C2 infrastructure

- 5.75.205[.]43 - Qakbot C2 infrastructure

- 184.176.35[.]223 - Qakbot C2 infrastructure

- 208.187.122[.]74 - Qakbot C2 infrastructure

- 23.111.114[.]52 - Qakbot C2 infrastructure

- 74.12.134[.]53 – Qakbot C2 infrastructure

- bonsars[.]com • 194.165.16[.]56 - Cobalt Strike C2 infrastructure

- 78.31.67[.]7 - VNC C2 infrastructure

Target URIs of GET Requests for Qakbot DLLs:

- /70802.dat

- /51881.dat

- /12427.dat

- /70136.dat

- /35768.dat

- /41981.dat

- /30622.dat

- /72286.dat

- /46557.dat

- /33006.dat

- /300332.dat

- /703558.dat

- /760433.dat

- /210/184/187737.dat

- /469/387/553748.dat

- /282/535806.dat

User-Agent Headers of GET Requests for Qakbot DLLs:

- curl/7.83.1

- curl/7.55.1

- Mozilla/5.0 (Windows NT; Windows NT 10.0; en-US) WindowsPowerShell/5.1.19041.2364

- Mozilla/5.0 (Windows NT; Windows NT 10.0; en-US) WindowsPowerShell/5.1.17763.3770

- Mozilla/5.0 (Windows NT; Windows NT 10.0; en-GB) WindowsPowerShell/5.1.19041.2364

SHA256 Hashes of Downloaded Qakbot DLLs:

- 83e9bdce1276d2701ff23b1b3ac7d61afc97937d6392ed6b648b4929dd4b1452

- ca95a5dcd0194e9189b1451fa444f106cbabef3558424d9935262368dba5f2c6

- fa067ff1116b4c8611eae9ed4d59a19d904a8d3c530b866c680a7efeca83eb3d

- e6853589e42e1ab74548b5445b90a5a21ff0d7f8f4a23730cffe285e2d074d9e

- d864d93b8fd4c5e7fb136224460c7b98f99369fc9418bae57de466d419abeaf6

- c103c24ccb1ff18cd5763a3bb757ea2779a175a045e96acbb8d4c19cc7d84bea

Names of Internally Distributed Qakbot DLLs:

- rpwpmgycyzghm.dll

- rpwpmgycyzghm.dll.cfg

- guapnluunsub.dll

- guapnluunsub.dll.cfg

- rskgvwfaqxzz.dll

- rskgvwfaqxzz.dll.cfg

- hkfjhcwukhsy.dll

- hkfjhcwukhsy.dll.cfg

- uqailliqbplm.dll

- uqailliqbplm.dll.cfg

- ghmaorgvuzfos.dll

- ghmaorgvuzfos.dll.cfg

Links Found Within Neutralized QakNote Email Attachments:

- hxxps://khatriassociates[.]com/MBt/3.gif

- hxxps://spincotech[.]com/8CoBExd/3.gif

- hxxps://minaato[.]com/tWZVw/3.gif

- hxxps://famille2point0[.]com/oghHO/01.png

- hxxps://sahifatinews[.]com/jZbaw/01.png

- hxxp://87.236.146[.]112/62778.dat

- hxxp://87.236.146[.]112/59076.dat

- hxxp://185.231.205[.]246/73342.dat

References

[1] https://techcommunity.microsoft.com/t5/excel-blog/excel-4-0-xlm-macros-now-restricted-by-default-for-customer/ba-p/3057905

[2] https://techcommunity.microsoft.com/t5/microsoft-365-blog/helping-users-stay-safe-blocking-internet-macros-by-default-in/ba-p/3071805

[3] https://learn.microsoft.com/en-us/deployoffice/security/internet-macros-blocked

[4] https://www.cyfirma.com/outofband/html-smuggling-a-stealthier-approach-to-deliver-malware/

[5] https://www.trustwave.com/en-us/resources/blogs/spiderlabs-blog/html-smuggling-the-hidden-threat-in-your-inbox/

[6] https://twitter.com/nao_sec/status/1530196847679401984

[7] https://www.fortiguard.com/threat-signal-report/4616/qakbot-delivered-through-cve-2022-30190-follina

[8] https://isc.sans.edu/diary/rss/28728

[9] https://darktrace.com/blog/qakbot-resurgence-evolving-along-with-the-emerging-threat-landscape

[10] https://www.trustwave.com/en-us/resources/blogs/spiderlabs-blog/trojanized-onenote-document-leads-to-formbook-malware/

[11] https://www.proofpoint.com/uk/blog/threat-insight/onenote-documents-increasingly-used-to-deliver-malware

[12] https://www.malwarebytes.com/blog/threat-intelligence/2023/03/emotet-onenote

[13] https://blog.cyble.com/2023/02/01/qakbots-evolution-continues-with-new-strategies/

[14] https://news.sophos.com/en-us/2023/02/06/qakbot-onenote-attacks/

[15] https://isc.sans.edu/diary/rss/29210

[16] https://unit42.paloaltonetworks.com/feb-wireshark-quiz-answers/

Written by

Sam Lister

Specialist Security Researcher

Written by

Connor Mooney

SOC Analyst

Inside the SOC

Written by

Sam Lister

Specialist Security Researcher

Written by

Connor Mooney

SOC Analyst

Director of Operational Technology

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OT

June 9, 2026

Healthcare’s OT Cybersecurity Gap: Why Hospitals Must Make the Same Security Investments as Regulated Critical Infrastructures

Rethinking the healthcare attack surface

When most people think about Operational Technology (OT) cybersecurity, they think about oil & gas pipelines, utilities, manufacturing plants, or power grids. However, hospitals & healthcare systems have quickly become a point of focus in the OT cybersecurity community as they do employ a variety of OT in the form of IoMT (Internet of Medical Things) networked devices such as: infusion pumps, imaging systems, patient monitoring equipment, laboratory systems, and traditional industrial control systems (ICS) in the form of smart building management systems (BMS) and even on site power generation control systems. 

These healthcare environments are no longer just traditional IT ecosystems, they are cyber-physical environments where disruption can directly impact patient care, operational continuity, and ultimately patient safety.

The OT cybersecurity expertise gap in healthcare organizations

Our research in the OT cybersecurity space revealed a concerning trend. Many hospitals and healthcare networks lack dedicated OT cybersecurity teams, OT security full time employees (FTE) and even OT expertise in the form of OT security certifications when compared to other critical infrastructure sectors. 

On the other hand, within industries such as energy and manufacturing, we encounter more mature OT security programs that employ full time employees  dedicated to OT cybersecurity with OT security certifications and expertise to secure industrial and operational environments and lead investment in OT security processes and technology.

When reviewing the top 20 U.S. Hospitals by market cap, given what is publicly available on LinkedIn, only one FTE with an OT cybersecurity certification was found. The certifications that were searched for include: GIAC GICSP, GIAC GRID, GIAC GCIP and all ISA/IEC 62443 certifications. When replicating this same search across the top 20 utility providers in the US, 73 FTEs with OT related certifications were identified. As a control group, we looked within financial services, an industry NOT expected to have OT systems worth investing in FTEs to protect. However, the top 20 US financial institutions had 18 FTEs with OT related certifications. 

What these findings reveal

Overall, the findings regarding healthcare investment in OT security FTEs are surprising given how operationally dependent modern healthcare has become on OT. So why aren't hospitals investing in OT security personnel at the rate of peer critical infrastructures? It could just be lack of awareness; however, there are other, more plausible reasons.

Based on historical trends in cyber incidents within the healthcare space, one could speculate that there is significantly greater likelihood of being victim to an attack that focuses on extortion or data theft rather than an attack on specific OT systems. The amount of ransomware events incurred in healthcare, that historically do not target OT systems, may divert attention and security investment to the parts of the attack surface most likely to be targeted by ransomware. Additionally, data theft is a relevant threat objective for hospitals given PHI, PCI and PII, and data theft does not traditionally align with attacks targeting OT.

However, with focused investment to address data theft and with adversaries new capability to string together chains of vulnerabilities of different severity scores using advancements in AI, we could be entering a threat landscape where adversaries pivot their tactics to target exposed and under protected devices and systems like OT. For example, although not a patient records database, predominant IOMT protocols HL7 and DICOM are unencrypted plaintext protocols and unless encrypted it is very simple for adversaries, who are sniffing traffic, to identify protected health information (PHI) in these communication protocols.

Why OT cybersecurity expertise can be effective for healthcare organizations

The convergence of IT, OT, and IoMT is already here, and threat actors are increasingly aware of the operational vulnerabilities that come with it. Additionally, as AI solutions such as agentic or generative applications are adopted and deployed, the attack surface will continue to change as permissions, and new connections will exist to support AI efficiency. From a cybersecurity standpoint, the reality is that many healthcare organizations are still working to establish consistent visibility and governance across their enterprise-connected devices and systems as their attack surface is changing in real time.  As the healthcare sector remains a significant target for cyber-attacks, hospitals would be well advised to begin addressing their operational environments OT as a critical component of their attack surface and invest in securing them first with people, then process and technology. 

What can healthcare organizations do to secure their OT

Including OT in current cybersecurity processes such as red teaming and testing incident response plans that take OT into account alongside building dedicated OT security capabilities including improving OT network visibility, leveraging OT network anomaly detection, micro-segmentation, and secure remote access will become essential steps in strengthening healthcare resilience. 

However, before any of the above processes or investments in technology can be made, these healthcare organizations, like the other critical infrastructure sectors, need to invest in the people with the experience in OT security to lead, implement, manage and audit the investment in OT cybersecurity technology and processes.  In cases where headcount cannot be added, investment in OT security certifications, such as the ones listed in this article, and participation on OT security events focused on practitioner training for existing cybersecurity employees can move the needle in terms of bringing OT expertise to the existing team.

In an industry where uptime and safety are as mission critical as they are for a power utility, OT cybersecurity FTEs can no longer be viewed as optional for healthcare organizations and must become part of the foundation of modern healthcare cybersecurity strategy. 

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About the author

Daniel Simonds

Director of Operational Technology

Blog

June 9, 2026

Always On, Always Defending: Inside the AI-Driven SOC

Today’s SOC: A system under pressure

The SOC has been described as the:

Control center for security systems management
Operations center for log analysis and alert response
Command center for network monitoring and investigation

But the CISO at a manufacturer of industrial power solutions says today’s SOC is far more dynamic:

“The SOC is an active player in a never-ending chess match where the pieces are always moving, the rules are constantly changing, and we’re continuously adjusting our tactical and strategic approaches to keep up.”

This has created a balancing act for cybersecurity professionals:

Support expanding digital estates to fuel innovation…or risk limiting business growth
Stop advanced cyberattacks at scale…or risk severe financial and reputational impacts

But balancing these responsibilities is increasingly difficult. Attackers are operating at machine speed and scale using sophisticated, adaptive techniques that overwhelm teams and bypass legacy defenses. At the same time, more than half of cybersecurity teams are understaffed, and 65% have unfilled cybersecurity positions (ISACA).

“The SOC is hitting its breaking point,” admits the VP of IT at a U.S.-based risk management services provider.”

“That’s the hard reality,” affirms a Chief Digital and Technology Officer at a North American financial services organization. “SOC teams are drowning in alerts, wasting time researching the most benign incidents while missing critical threats.”

Traditional tools lack the context and autonomous reasoning needed to determine which ones are truly dangerous, requiring analysts to manually review and respond. But with thousands of alerts hitting SOCs daily, the task exceeds human capacity, with recent industry research revealing that 40% to 42% of security alerts now go uninvestigated.

“Our old governance models of throwing bodies at it, that’s not going to work,” says the Group CIO of a multinational holding company. “Attackers move at machine speed, and our defenses have to operate at the same pace. Using AI for cybersecurity is the only way to do that.”

Why AI is essential

AI is about speed, scale, and context.

SOC teams are still expected to find the proverbial “needle in a haystack”, but the haystack keeps growing. As digital infrastructures expand and threat actors use AI to rapidly scale attacks and exploit vulnerabilities, success isn’t about keeping up but changing the approach.

This is where AI comes in, enabling security teams to operate at machine speed and scale by:

Analyzing vast amounts of data and correlating signals across domains within seconds
Detecting possible threats in real time and taking immediate action to mitigate risk
Prioritizing threats by severity and uncovering contextual details for rapid triage

The power of AI isn’t theoretical; it is transforming how today’s businesses operate.

The Chief Digital and Technology Officer at a financial services firm says within a single month of using Darktrace, the solution tracked billions of network events, autonomously investigated tens of millions of those incidents, and added the equivalent of 1,000 analyst hours of investigation. It also found threats that bypassed traditional tools, autonomously responding to contain or disrupt the threat on over 30,000 emails, including 18,000 the firm’s native email filter missed.

When Darktrace says it “takes action on a threat,” it generally means its platform can move beyond just detecting suspicious activity and automatically respond to contain or disrupt the threat—such as isolating a device, slowing or blocking suspicious network traffic, disabling risky user activity, or triggering security workflows—depending on how the system is configured.

AI isn’t about displacing humans.

AI is a powerful tool for handling large-scale data analysis, pattern detection, and repetitive tasks, but it cannot replace human critical thinking. By removing mindless work that does not require judgment, AI frees analysts to focus on what humans do best: applying reasoning, context, and sound decision-making to complex threats.

“AI is a workforce maximizer,” says the Chief Digital and Technology Officer. “It augments our team by monitoring and detecting threats at a scale beyond human capacity while providing the critical context we need to make faster, more confident decisions.

Rather than replacing people, AI is changing how security professionals work. Analysts can reclaim time previously spent on tedious, manual triage to focus on higher priorities and proactive initiatives like advanced threat hunting, strategic risk management, and security enablement and training.

“Aside from risk mitigation, our biggest ROI is in efficiency,” says the Head of Security at global business services provider. “What used to take 90% of our investigation time is now handled automatically, so we can focus on the final 10%, which requires critical thinking."

For SOC teams under pressure, the impact can be transformative, with security leaders reporting significant real-world outcomes using Darktrace Self-Learning AI^TM, including:

Phishing emails reduced by 99%
1 million+ emails autonomously analyzed each month, with no email-based incidents reported
Potential threats autonomously neutralized in under four seconds, on average
99% of investigations conducted autonomously, surfacing only the high-priority 1% of threats for analyst review

How AI optimizes the SOC

To protect the modern enterprise, you absolutely need the right tools,” says CTO at leading European fashion brand. “Without them you’re a victim. With them, you’re a defender. AI and the machine speed detect/response it enables makes it the most critical tool.”

Replacing chaos with clarity and control

It’s important to note that different AI solutions address different needs. Companies should clearly understand their specific use case and select the solution that best aligns with their goals, requirements, and operational needs.

When it comes to choosing cybersecurity in a machine-speed threat landscape, time is the most valuable resource. Organizations require AI that can move from insight to action by:

Learning an organization’s unique behavioral patterners
Correlating signals across domains to detect anomalous activity
Prioritizing events and autonomously responding at scale to the vast majority
Quarantining high-impact threats until the SOC can investigate
Arming analysts with deep, contextual information to accelerate investigations

“Darktrace AI gives us threat detections based on facts, not guesses,” says the Group CIO. “It moves the SOC beyond alert overload to confident, informed decision-making. When Darktrace flags something, we pay attention. False positives are very rare, so we act with speed and confidence without second-guessing.”

Replacing anxiety with confidence and peace of mind

Every missed alert can have real-world consequences.

The strain of maintaining constant vigilance at scale without holistic visibility and automation is taking its toll on security professionals: 66% report increased stress, and nearly half say it’s the reason they’re leaving the field (ISACA).

The CIO at a professional sports organization says that’s not surprising: “If you don’t know what’s going on, anything could be happening. Operating with that level of uncertainty and control is incredibly stressful.”

AI gives SOCs the power to be proactive by unifying telemetry across network, email, identity, and cloud environments to provide a complete picture and a stronger foundation for action. The benefits for analysts, both personally and professionally, are significant:

Achieve greater work-life balance: “Knowing that Darktrace has our backs 24/7 and will take immediate action to stop threats means we can now work normal hours and take vacations without worrying,” says the Chief Digital and Technology Officer.
Feel in control with deeper insights: “It not only stops and quarantines threats but also provides the deep context we need to quickly investigate and respond,” explains the Head of Security.
Gain confidence the business is protected 24/7: “We can sleep at night. With Darktrace I’m confident that even with a small team we can protect the business 24/7,” adds the former retail CIO.

The modern SOC: A system of balance

Elevated to a core pillar of business strategy, the modern SOC is now considered:

The nerve center of cyber risk and proactive defense
The AI-powered command center for operational resilience
The strategic hub for contextual decision-making at scale

The SOC has evolved from a reactive center responsible for managing systems into a proactive, frontline defender and strategic business enabler—integral to innovation and growth.

AI is the key to balancing these responsibilities.

“We can only grow as fast as we can secure the business,” says the Head of Security. “AI gives us the speed, scale, and confidence to do both.”

*Metrics are based on the customer’s interview, data and sourced from its monthly Cyber AI Insights reporting.

About the author

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Check out this article by Darktrace: Understanding Qakbot Infections and Attack Paths

Understanding Qakbot Infections and Attack Paths

Qakbot and The Recent Weaponization of OneNote

Observed Activity Chains

Delivery Phase

Command and Control Phase

Cobalt Strike and VNC Phase

Lateral Movement Phase

Darktrace Coverage of QakNote Activity

Conclusion

Appendices

MITRE ATT&CK Mapping

List of IOCs

References

When Open Source Is Weaponized: Analysis of a Trojanized 7 Zip Installer

Healthcare’s OT Cybersecurity Gap: Why Hospitals Must Make the Same Security Investments as Regulated Critical Infrastructures

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June 9, 2026

Healthcare’s OT Cybersecurity Gap: Why Hospitals Must Make the Same Security Investments as Regulated Critical Infrastructures

Rethinking the healthcare attack surface

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What can healthcare organizations do to secure their OT

Blog

June 9, 2026

Always On, Always Defending: Inside the AI-Driven SOC

Today’s SOC: A system under pressure

Why AI is essential

AI is about speed, scale, and context.

AI isn’t about displacing humans.

How AI optimizes the SOC

Replacing chaos with clarity and control

Replacing anxiety with confidence and peace of mind

The modern SOC: A system of balance