CISA ICSMA-26-223-01: Mira Hormone Monitor & Android App Critical Flaws (CVSS 9.8) — Healthcare IoMT Detection and Remediation Guide

CISA has published ICS Medical Advisory ICSMA-26-223-01 covering a cluster of critical vulnerabilities in the Mira Hormone Monitor (firmware 1.7.1.47) and its companion Mira Android App (version 4.5.15.4), developed by Quanovate Tech Inc. (operating as Mira / Mira Care). The advisory carries a CVSS v3 score of 9.8 — Critical.

Successful exploitation of these vulnerabilities could allow an attacker to:

• Access unauthorized health profile information
• Modify patient health information
• Cause a denial-of-service condition
• Disclose session token information
• Obtain control of user accounts

This is not a theoretical consumer-gadget problem. Mira devices are FDA-registered hormone monitoring systems used in fertility clinics, OB/GYN practices, telehealth programs, and increasingly in clinical settings where the data feeds into patient care decisions. Compromised health data here is HIPAA-regulated PHI, tampered results could influence clinical decisions, and session token disclosure plus account takeover gives an attacker a persistent foothold into patient-facing cloud infrastructure. If your organization deploys, recommends, or integrates Mira devices — or if your clinicians' and patients' data flows through the Mira cloud ecosystem — this advisory requires action this week, not this quarter.

Technical Analysis

Affected Products and Versions

CVE Identifiers

The advisory enumerates eight CVEs, applied to both the firmware and the Android application:

• CVE-2026-66875
• CVE-2026-66098
• CVE-2026-67558
• CVE-2026-67568
• CVE-2026-68067
• CVE-2026-66340
• CVE-2026-64934
• CVE-2026-66832

The advisory aggregates these under a CVSS v3 base score of 9.8, indicating at least one vulnerability in the chain is network-exploitable, requires no authentication or user interaction, and results in full confidentiality/integrity impact. The full CSAF document is available via the CISA advisory page.

Attack Chain — Defender's Perspective

Based on the stated impacts, the attack surface spans three layers, and defenders should model all three:

1. Device-to-cloud API layer. Session token disclosure and unauthorized access to health profiles point to weaknesses in the mobile app's API communication — classically insufficient transport protection, tokens passed in URLs or logged to device logs, missing certificate validation, or broken object-level authorization (BOLA/IDOR) where one authenticated user can reference another user's health records by manipulating identifiers in API requests.

2. Account control layer. Account takeover combined with session token disclosure strongly suggests token theft leading to session hijacking, or weaknesses in authentication/token refresh flows. An attacker holding a valid session token bypasses MFA entirely — this is why the token disclosure CVEs matter as much as the account-takeover CVEs.

3. Firmware layer. Denial-of-service against the monitor itself and modification of health information implies the firmware accepts unauthenticated or poorly validated input — either over its local network interface or via the paired app. In a clinical environment, a DoS against monitoring hardware during an active patient workflow is a patient-safety issue, not just an availability metric.

Exploitation Status

As of publication, CISA has not reported confirmed in-the-wild exploitation, and none of these CVEs appear in the CISA Known Exploited Vulnerabilities (KEV) catalog. However, a 9.8 CVSS score on an internet-adjacent medical IoT ecosystem with session token disclosure is precisely the profile that attracts both opportunistic attackers and researchers publishing proof-of-concept code. Treat the pre-exploitation window as short. Healthcare IoMT remains one of the least-monitored segments of most enterprise networks — attackers know this.

Detection & Response

A candid note before the rules: the Mira monitor and Android app are not Windows endpoints, and most exploitation activity will manifest in network telemetry (proxy, firewall, DNS, NetFlow) and cloud/API logs rather than endpoint process events. The detections below are built for that reality. Tune the domain selections to the exact vendor infrastructure you observe in your environment — confirm the actual Mira cloud domains from your own DNS/proxy data before deploying at scale.

Sigma Rules

---
title: Suspicious API Request Patterns to Mira Health Cloud Endpoints
description: Detects high-volume or enumeration-style HTTP requests to Mira / Quanovate cloud infrastructure consistent with BOLA/IDOR health record access or account takeover attempts described in ICSMA-26-223-01.
references:
  - https://www.cisa.gov/news-events/ics-medical-advisories/icsma-26-223-01
  - https://attack.mitre.org/techniques/T1530/
author: Security Arsenal
date: 2026/08/11
status: experimental
tags:
  - attack.collection
  - attack.t1530
logsource:
  category: proxy
detection:
  selection_domain:
    c-uri|contains:
      - 'miracare'
      - 'mira-care'
      - 'quanovate'
  selection_api:
    c-uri|contains:
      - '/api/'
      - '/v1/'
      - '/v2/'
  selection_method:
    c-method:
      - 'GET'
      - 'PUT'
      - 'POST'
  condition: selection_domain and selection_api and selection_method
falsepositives:
  - Legitimate app synchronization traffic; alert on volume thresholds and sequential identifier patterns in your SIEM rather than single events
level: medium
---
title: Plaintext Token or Session Parameter Transmission to Health IoT Endpoints
id: 3f8c1a72-5b9d-4e2a-9c6f-7d1e2b3a4c5d
status: experimental
description: Detects session tokens or authentication parameters transmitted in cleartext HTTP query strings to health monitoring cloud domains, consistent with the session token disclosure weaknesses in ICSMA-26-223-01.
references:
  - https://www.cisa.gov/news-events/ics-medical-advisories/icsma-26-223-01
  - https://attack.mitre.org/techniques/T1552/
author: Security Arsenal
date: 2026/08/11
tags:
  - attack.credential_access
  - attack.t1552
logsource:
  category: proxy
detection:
  selection_scheme:
    c-uri|startswith: 'http://'
  selection_token:
    c-uri|contains:
      - 'token='
      - 'session='
      - 'sessionid='
      - 'auth='
      - 'access_token='
  selection_health:
    c-uri|contains:
      - 'mira'
      - 'quanovate'
      - 'hormone'
      - 'health'
  condition: selection_scheme and selection_token and selection_health
falsepositives:
  - Legacy integrations using HTTP; any hit here is itself a finding worth investigating as a data exposure risk
level: high
---
title: Denial-of-Service Traffic Volume Against Medical IoT Device Segments
description: Detects abnormal connection volume targeting VLANs or subnets hosting connected medical monitoring devices, consistent with the denial-of-service impact described in ICSMA-26-223-01.
references:
  - https://www.cisa.gov/news-events/ics-medical-advisories/icsma-26-223-01
  - https://attack.mitre.org/techniques/T1498/
author: Security Arsenal
date: 2026/08/11
tags:
  - attack.impact
  - attack.t1498
logsource:
  category: firewall
detection:
  selection:
    dst_zone: 'IoMT'
    action: 'allow'
  condition: selection
falsepositives:
  - Normal device telemetry; deploy as an aggregate/threshold rule in your SIEM (e.g., >100 connections per minute to a single device IP from a non-gateway source)
level: medium

KQL — Microsoft Sentinel / Defender

The following hunts assume proxy/firewall data is ingested into CommonSecurityLog (CEF) and DNS into your DNS table. Run the first query to baseline your actual Mira cloud domains, then operationalize the second as an analytics rule with a threshold.

// Step 1: Baseline all observed traffic to Mira / Quanovate infrastructure (last 7 days)
CommonSecurityLog
| where TimeGenerated > ago(7d)
| where RequestURL has_any ("mira", "quanovate") or DestinationHostName has_any ("mira", "quanovate")
| summarize ConnectionCount = count(), UniqueSources = dcount(SourceIP), FirstSeen = min(TimeGenerated), LastSeen = max(TimeGenerated)
  by DestinationHostName, RequestURL, SourceIP
| order by ConnectionCount desc;

// Step 2: Hunt for enumeration patterns — single source hitting many distinct API paths (BOLA/IDOR behavior)
CommonSecurityLog
| where TimeGenerated > ago(24h)
| where RequestURL has_any ("mira", "quanovate")
| where RequestURL has_any ("/api/", "/v1/", "/v2/", "user", "profile", "patient", "result")
| summarize DistinctPaths = dcount(RequestURL), TotalRequests = count(), DistinctAccounts = dcount(RequestContext)
  by SourceIP, bin(TimeGenerated, 1h)
| where DistinctPaths > 50 or TotalRequests > 500
| order by TotalRequests desc;

// Step 3: Hunt for cleartext token transmission (session token disclosure exposure)
CommonSecurityLog
| where TimeGenerated > ago(24h)
| where RequestURL startswith "http://"
| where RequestURL has_any ("token=", "session=", "sessionid=", "access_token=", "auth=")
| where RequestURL has_any ("mira", "quanovate", "hormone", "fertility")
| project TimeGenerated, SourceIP, DestinationIP, RequestURL, RequestMethod
| order by TimeGenerated desc;

// Step 4: DNS anomalies — lookups for Mira domains from unexpected segments (non-IoMT, non-guest)
DnsEvents
| where TimeGenerated > ago(24h)
| where Name has_any ("mira", "quanovate")
| summarize QueryCount = count(), DistinctClients = dcount(ClientIP) by ClientIP, Name
| order by QueryCount desc;

Velociraptor VQL

For corporate-owned Android devices enrolled in your fleet, direct Velociraptor coverage is limited — but for Windows workstations used by clinical staff to access Mira web portals, and for validating egress from your network, the following hunts are useful. The first hunts browser/OS artifacts for Mira session data exposure on endpoints; the second sweeps live network connections to vendor infrastructure.

-- Hunt live connections from endpoints to Mira / Quanovate cloud infrastructure
-- Resolve vendor IP ranges from your DNS baseline first, then filter here
SELECT Pid, Name, Exe, Username, netstat().RemoteIP AS RemoteIP,
       netstat().RemotePort AS RemotePort, netstat().Status AS Status
FROM pslist()
WHERE Name =~ '(?i)chrome|firefox|edge|msedge'
   OR Exe =~ '(?i)program files'

-- Sweep DNS cache artifacts for Mira-related lookups to identify exposed endpoints
SELECT Fqdn, Data, Type, Timestamp
FROM glob(globs='C:\\Windows\\System32\\dns\\*.log')
WHERE Fqdn =~ '(?i)mira|quanovate'

A more practical Velociraptor deployment for this advisory is a fleet-wide artifact checking for Mira-related URLs in browser history (Chrome History SQLite) on clinical workstations, to scope which staff accounts actually interact with the Mira ecosystem and therefore need credential resets:

-- Identify users with Mira portal activity in Chrome history to scope account reset efforts
SELECT * FROM Artifact.Windows.Forensics.History()
WHERE Url =~ '(?i)mira|quanovate'

Remediation and Verification Script

The following Bash script is designed for your network/security infrastructure to (a) audit egress traffic to Mira cloud infrastructure from proxy logs, (b) verify DNS sinkhole or blocklist coverage if you choose to temporarily restrict access pending patching, and (c) generate an inventory checklist for affected versions.

#!/bin/bash
# ICSMA-26-223-01 verification and exposure audit — Security Arsenal
# Run on a Linux jump host with access to proxy/firewall logs

LOG_DIR="/var/log/proxy"   # adjust to your proxy log path (Squid/Zeek http.log works)
OUT="mira_exposure_audit_$(date +%Y%m%d).txt"

echo "=== Mira Ecosystem Exposure Audit — ICSMA-26-223-01 ===" | tee "$OUT"
echo "Date: $(date -u)" | tee -a "$OUT"

# 1. Identify all observed Mira/Quanovate domains in proxy logs (last 30 days)
echo -e "\n[1] Observed vendor domains (baseline your allowlist from this):" | tee -a "$OUT"
zgrep -hiE 'mira|quanovate' "$LOG_DIR"/*.log* 2>/dev/null \
  | grep -oE '([a-zA-Z0-9.-]+\.)?(mira[a-z]*|quanovate)\.[a-z]{2,}' \
  | sort | uniq -c | sort -rn | tee -a "$OUT"

# 2. Flag cleartext HTTP requests carrying token-like parameters
echo -e "\n[2] Cleartext token transmission (session token disclosure exposure):" | tee -a "$OUT"
zgrep -hiE 'http://[^ ]*(token=|session=|sessionid=|access_token=|auth=)[^ ]*(mira|quanovate|hormone)' \
  "$LOG_DIR"/*.log* 2>/dev/null | head -50 | tee -a "$OUT"

# 3. Flag high-volume sources (enumeration / DoS indicators)
echo -e "\n[3] Top source IPs by request volume to Mira infrastructure:" | tee -a "$OUT"
zgrep -hiE 'mira|quanovate' "$LOG_DIR"/*.log* 2>/dev/null \
  | awk '{print $1}' | sort | uniq -c | sort -rn | head -20 | tee -a "$OUT"

# 4. Verify DNS resolution path for vendor domains (confirms whether egress controls apply)
echo -e "\n[4] DNS resolution check for known vendor domains:" | tee -a "$OUT"
for d in $(grep -oE '([a-zA-Z0-9.-]+\.)?(mira[a-z]*|quanovate)\.[a-z]{2,}' "$OUT" | sort -u | head -10); do
  echo "$d -> $(dig +short "$d" | tr '\n' ' ')" | tee -a "$OUT"
done

echo -e "\n=== Audit complete. Review $OUT and escalate cleartext-token or enumeration findings to IR. ==="

For version verification of the Android app across a managed fleet, query your MDM (Intune, Workspace ONE, etc.) for installed application inventory rather than attempting endpoint scripts — Android app version enumeration is an MDM function. Any device reporting Mira Android App 4.5.15.4 or earlier and any monitor on firmware 1.7.1.47 or earlier goes on the remediation list.

Remediation

Immediate actions (this week):

1. Patch both components. Update the Mira Android app to the latest release via Google Play and update Mira Monitor firmware per Quanovate's update instructions. Monitor the CISA advisory ICSMA-26-223-01 and the vendor's support channels for the fixed version numbers — CISA directs users to the vendor for update availability. Do not assume auto-update has run; verify versions explicitly via MDM inventory and device settings.

2. Force credential and session resets. Because the advisory explicitly covers session token disclosure and account takeover, assume tokens issued to affected app versions may be compromised. Force logout of all sessions and require password resets for any account that authenticated from app version 4.5.15.4. If the vendor supports it, revoke all active refresh tokens server-side.

3. Segment the devices. Mira monitors and the phones running the companion app should live on a dedicated IoMT/guest VLAN with no lateral path to clinical workstations, EHR infrastructure, or medical devices on your primary network. If the monitor communicates outbound only, enforce egress filtering so it can reach only verified Mira cloud domains.

4. Restrict network exposure. Per CISA's standard ICS guidance: do not expose these devices to the internet directly, place control-system-adjacent networks behind firewalls, and isolate them from business networks. Where remote access is required, use updated VPNs — recognizing the VPN is only as strong as its own patch level.

Near-term (30 days):

5. Assess PHI exposure. If your organization is a covered entity or business associate under HIPAA, work with your privacy officer to determine whether the unauthorized-access and data-modification impacts require a breach risk assessment. Document the timeline of affected versions in your environment against the advisory publication date.

6. Deploy the detections above as Sentinel analytics rules or SIEM equivalents, with thresholds tuned from your Step 1 baseline query.

7. Review vendor risk. Add Quanovate/Mira to your third-party risk register. Request their coordinated disclosure timeline, patch cadence commitment, and a software bill of materials (SBOM) for the monitor firmware — a reasonable ask under current FDA premarket cybersecurity guidance for medical devices.

Ongoing:

8. Subscribe to CISA ICS medical advisories and ensure your vulnerability management process ingests ICSMA feeds — medical IoT advisories routinely fall outside traditional IT vuln-scanning coverage because the assets aren't in the scanner's scope.

9. Establish social-engineering awareness for staff: CISA reminds defenders that attackers frequently pair technical exploits with phishing against product users. Any email claiming to be "Mira support" requesting credentials or app reinstallation should route through your security team.

Bottom Line

A CVSS 9.8 cluster spanning firmware and mobile app, with session token theft and account takeover on the table, is a serious advisory even without confirmed exploitation. The healthcare sector's history with IoMT is clear: these devices are deployed, forgotten, and rarely monitored. Close the patch gap, rotate the credentials, segment the devices, and put eyes on the network path between them and the vendor cloud. That's the whole job this week.

Related Resources

Security Arsenal Managed SOC Services AlertMonitor Platform Book a SOC Assessment soc-mdr Intel Hub