Marco Serale, Marco Filippi
RESEARCH - Published on Saturday, the 14th of November 2026
No conflict of interest declared. No research grants received.
In October and November 2026, refrigeration controls at supermarkets in France and other European countries were altered remotely. On 1–2 November, tampering also reached three plasma storage sites of the French Blood Establishment (EFS) via a compromised supplier; alarms and staff prevented losses. Perpetrators remain unidentified, and a hybrid origin is unproven. The episode shows why cyber exposure in operational technology matters for blood, plasma, and high-value medicines, whose loss cannot be repaired through digital recovery alone. The experience of Ukraine and a 2026 U.S. military review of Israeli medical operations further identify blood availability as a critical determinant of medical operational readiness. We propose integrating physical security, transfusion quality, cyber resilience, civilian EMS/HEMS capability and national civil–military preparedness. These are preparedness recommendations, not evidence of coordinated attacks against the blood supply.
Topics & Keywords
Cold Chain
Operational Technology
Blood Supply
Medical Intelligence
Forward Blood
TCCC
TECC
EMS/HEMS
Physical Sabotage
Hybrid Threats
Document Details and Availability
Copyright: CTM-E, authors, for noncommercial use only
Availability: Website Only
Year: 2026
Pages: 16
Document Identification Number: RA 1021
Cite this Report
APA
Serale, M., & Filippi, M. (2026). Cold chain under attack: A warning for blood, plasma and high-cost medicines – Medical intelligence and national blood resilience. CTM-E Counter-Terrorism Medicine Europe. https://www.ctm-e.org/research-and-analysis/RA1021
MLA
Serale, Marco, and Filippi, Marco. Cold Chain Under Attack: A Warning for Blood, Plasma and High-Cost Medicines – Medical Intelligence and National Blood Resilience. CTM-E Counter-Terrorism Medicine Europe, 2026, www.ctm-e.org/research-and-analysis/RA1021.
Chicago
Serale, Marco and Filippi Marco, Cold Chain under Attack: a Warning for Blood, Plasma and High-Cost Medicines - Medical Intelligence and National Blood Resilience, Tallinn, Estonia: CTM-E Counter-Terrorism Medicine Europe, 2026. https://www.ctm-e.org/research-and-analysis/RA1021
RESEARCH CONDUCTED BY
CTM-E Medical Intelligence (MEDINT) Research Division
