Nearly 500 people have been killed in an Israeli air attack on the Al-Ahli Arab Hospital in the besieged Gaza Strip, Palestinian officials have said.

The health ministry in Gaza said the blast at the hospital was caused by an Israeli air raid. Israel has attributed the explosion to a misfired rocket launched by the Palestinian Islamic Jihad (PIJ) armed group. The PIJ has denied the allegation.

Al Jazeera was not able to independently verify the accounts.

As tensions continue to rise, here is what we know so far about the strike:

Hundreds killed

The health ministry in Gaza says at least 471 people were killed in the blast, by far the highest death toll of any single incident in Gaza during the current war between Israel and Hamas.

The ministry said hundreds of other victims remained under the rubble.

Hamas said the blast mostly killed displaced people.

The Palestinian Authority’s health minister, Mai Alkaila, accused Israel of carrying out “a massacre”.

Located in central Gaza, the hospital, which is run by the Episcopal Diocese of Jerusalem, was struck while it was overwhelmed with thousands of Palestinians seeking shelter amid a campaign of brutal Israeli air attacks across much of the besieged Gaza Strip.

How has the world reacted?

World leaders have denounced the bombing, with leaders from across the Middle East issuing the firmest statements.

Protests have also erupted across the Middle East, including in Jordan and in the Israeli-occupied West Bank where Palestinian protests have confronted the Palestinian Authority’s security forces.

Jordan has cancelled a planned summit in the capital of Amman with United States President Joe Biden and Arab leaders.

Jordan’s Foreign Minister Ayman Safadi said the meeting would be held at a time when all present could agree to work towards ending the “war and the massacres against Palestinians”.

Egyptian President Abdel Fattah el-Sisi, who had also been slated to attend the summit, said he condemned “in the strongest possible terms Israel’s bombardment” of the Gaza hospital.

Saudi Arabia also issued a firm statement, condemning “in the strongest possible terms the heinous crime committed by the Israeli occupation forces by bombing Al Ahli Baptist Hospital in Gaza”.

Western leaders did not blame Israel for the strike, with French President Emmanuel Macron saying in a social media post that “nothing can justify a strike against a hospital” and adding that “all the light must be shed on the circumstances”.

Nothing can justify striking a hospital.
Nothing can justify targeting civilians.

France condemns the attack on the Al-Ahli Arab hospital in Gaza, which made so many Palestinian victims. Our thoughts are with them. All the light must be shed on the circumstances.

— Emmanuel Macron (@EmmanuelMacron) October 17, 2023

Biden in a statement offered “deepest condolences for the innocent lives lost in the hospital explosion in Gaza”.

What does Israel say?

Israeli authorities said the hospital was hit by an errant rocket fired by Palestinian Islamic Jihad, which operates inside the Gaza Strip.

“An analysis of IDF [Israel’s army] operational systems indicates that a barrage of rockets was fired by terrorists in Gaza, passing in close proximity to the Al Ahli hospital in Gaza at the time it was hit,” Israeli Prime Minister Benjamin Netanyahu said in a social media post.

“Intelligence from multiple sources we have in our hands indicates that Islamic Jihad is responsible for the failed rocket launch which hit the hospital in Gaza.”

Israeli military spokesperson Rear Admiral Daniel Hagari told reporters rockets fired by the PIJ passed by the hospital at the time of the strike, which he said hit the facility’s parking lot.

Hagari claimed there was no direct hit on the facility and said military drone footage showed “a kind of hit in the parking lot”.

He said the military did have an Israeli Air Force operation in the area around the time of the hospital blast “but it was with a different kind of ammunition that does not … fit the footage that we have [of] the hospital.”

What does PIJ say?

The PIJ has rejected the Israeli allegation that it was responsible for the strike.

“The Zionist enemy is trying hard to evade its responsibility for the brutal massacre he committed by bombing the Baptist Arab National Hospital in Gaza through his usual fabrication of lies, and through pointing the finger of blame at the Islamic Jihad movement in Palestine,” it said in a statement.

“We therefore affirm that the accusations put forward by the enemy are false and baseless,” it added.

Al Jazeera’s Imran Khan noted that some observers have questioned Israel’s version of events, with some pointing to Israel’s history of falsely attributing acts carried out by its own forces to armed Palestinian groups.

“We’ve seen this type of thing before from the Israelis,” Khan said on Tuesday.

“Take for example the killing of our colleague Shireen Abu Akleh. At the initial stages of that report, the Israelis blamed fighters within Jenin camp for her death. It was only later that they admitted it was one of theirs.”