Israel kept up its barrage of the Gaza Strip on Thursday despite intensifying international calls to reduce civilian casualties from its bombardment as a surge in deadly diseases sweeps through displaced residents.

Israel says its attacks on Gaza are aimed at annihilating Hamas, the group whose fighters stormed across the border fence from Gaza on Oct. 7, killing 1,200 Israelis, mostly civilians, and seizing 240 hostages.

Since then, Israel has laid much of the Palestinian enclave to waste. At least 18,608 people have been killed and 50,594 injured in Israeli strikes on Gaza, according to Gaza's health ministry.

The vast majority of the population of 2.3 million has fled their homes, many sleeping rough, leaving them vulnerable to illness.

At Nasser hospital in Khan Younis, where the trauma ward has been overwhelmed with the wounded, sick babies were also crammed several to a bed in the children's ward.

"A number of patients come with cases of extreme dehydration, some of which can get to the point of kidney failure or weakening kidney function," said Dr Ahmed al-Farra, head of pediatrics.

There had already been up to 30 cases of hepatitis A, which takes up to a month to incubate, he said.

"So after a month there will be an explosion in the number of cases of hepatitis A, and this is a very dangerous indicator that should be paid attention to, from overcrowding and consuming food not fit for human consumption and using shared toilets," he said.

The coastal strip is now facing a public health disaster due to the collapse of its health system and the spread of disease, the U.N. humanitarian office said.

"We've got a textbook formula for epidemics and a public health disaster," said Lynn Hastings, the U.N. Humanitarian Coordinator for the Occupied Palestinian Territory.

In central Rafah, in the south of the coastal enclave, 24 people were killed in an Israeli strike that hit two houses, Hamas media said early on Thursday. There was no immediate confirmation from the Palestinian health ministry.

White House national security adviser Jake Sullivan, who is visiting the region and will be in Israel on Thursday and Friday, would discuss with the Israelis the need to be more precise with their strikes against Hamas targets, spokesperson John Kirby told reporters.

Nearly half of the air-to-ground munitions that Israel has used in Gaza in its war with Hamas since Oct. 7 have been unguided, otherwise known as "dumb bombs," according to a U.S. intelligence assessment reported by CNN.

About 40-45% of the 29,000 air-to-ground munitions Israel has used have been unguided and the rest have been precision-guided munitions, the CNN report said.

TANKER ATTACKED

Fears of the conflict spreading in a volatile region remain.

A tanker in the Red Sea off Yemen's coast was fired on by gunmen in a speedboat and targeted with missiles, maritime sources said on Wednesday. It is the latest incident to threaten the vital shipping lane after Yemeni Houthi forces, which are backed by Iran, warned ships not to travel to Israel.

The cost of the Israel-Hamas war to neighbours Lebanon, Egypt and Jordan in terms of loss of GDP may amount to $10.3 billion or 2.3%, and might double if the conflict lasts six more months, a study commissioned by the U.N. Development Programme said.

The Biden administration is delaying the sale to Israel of more than 20,000 U.S.-made rifles over concerns about increasing attacks by Israeli settlers on Palestinians in the West Bank, two sources familiar with the matter said.

Some 271 Palestinians have been killed by Israeli security forces, including 69 children, in the occupied West Bank this year, the U.N. Palestinian refugee agency said.

At least 288 displaced people in shelters run by the agency have been killed in Gaza since Oct. 7, the agency added in a post on X.

The number of Israeli soldiers killed in the ground offensive has reached 115, and more than 600 wounded, according to an Israeli military website.

"Your heroism, and of those who unfortunately fell and we couldn’t bring them to this state of rehabilitation, are the light which repels the darkness, and in this room there is so much light," Lieutenant General Herzi Halevi, chief of Israel's General Staff, told wounded soldiers during a ceremony for the Jewish festival of Hanukkah in Ramat Gan.

PROTESTS, VIGILS

Some Biden administration staffers held a vigil in front of the White House late on Wednesday to call on Washington to support a ceasefire in Gaza.

The group of around 60 people carried a banner that read: "President Biden, your staff demands a ceasefire."

"We were horrified by the brutal October 7 attacks on Israeli civilians, and have been horrified by the disproportionate response by the Israeli government, which has indiscriminately killed thousands of innocent Palestinian civilians in Gaza and displaced over a million more," the protesters said in a statement read by Josh Paul, a former State Department official who resigned a few weeks ago.

In New York, a demonstration was held demanding the release of the remaining 135 hostages held in Gaza.

Most Israelis say the army should not back off its unrelenting offensive to crush Hamas.

"It's awful. It's awful that there are so many civilian casualties," said Jerusalem resident Adam Saville. "But this is war, and that's what happens in war."