Dr. Fadel Naim, director of the Al-Ahly Hospital in Gaza City, said the dead include nine women, and that the toll was likley to rise as rescue efforts continue.

He said they were killed in a strike on a home in the urban refugee camp of Jabaliya, where Israel has been carrying out an offensive for over a month.

There was no immediate comment from the Israeli military.

Israeli forces have encircled and largely isolated Jabaliya and the nearby towns of Beit Lahiya and Beit Hanoun for the past month, allowing in only a trickle of humanitarian aid. Tens of thousands of people have fled to nearby Gaza City.

The entire northern third of Gaza was the first target of Israel’s ground invasion and has suffered the heaviest destruction of the 13-month-old war, which was triggered by Hamas’ attack into southern Israel.

Israeli forces have repeatedly returned to parts of Gaza where they had operated previously, saying Hamas militants had regrouped.