DEIR AL-BALAH, Gaza Strip (AP) — Israel launched ground operations and carried out airstrikes in a hard-hit city in southern Gaza overnight.

Palestinian medical officials said Wednesday that the attacked killed at least 51 people, including women and children.

Israel has continued to strike what it says are militant targets across Gaza nearly a year after Hamas’ Oct. 7 attack ignited the war in the Palestinian territory, and even as attention has shifted to Lebanon and Iran.

Israeli ground troops have carried out incursions into Lebanon against Hezbollah, and Tehran fired a barrage of ballistic missiles on Israel late Tuesday.

The escalation on multiple fronts has raised fears of a wider war in the Middle East that could draw in Iran and the United States.