BEIRUT: A Hezbollah attack on northern Israel’s Metula killed five people including an Israeli farmer and four foreign workers, Israel’s Channel 12 reported on Thursday as Lebanon said Israeli strikes killed six health workers in the country’s south.

U.S. envoys and Israeli officials were due to meet in Israel later to discuss efforts towards a ceasefire in both Lebanon, where Israeli forces are battling Iran-backed Hezbollah, and in Gaza, where they are fighting Hamas Palestinian militants.

Israel issued an evacuation warning to residents of Baalbek in eastern Lebanon for a second consecutive day. On Wednesday it conducted heavy airstrikes targeting Hezbollah in and around the city, which is famed for its Roman temples.

Dozens of cars could be seen speeding out of the area after Thursday’s warning, with wafts of black smoke still visible emanating from the town of Douris, where an Israeli strike the previous day destroyed Hezbollah fuel stocks, according to the Israeli military and a Lebanese security source.

Thousands fleeing the violence have sought shelter in the nearby Christian-majority town Deir al-Ahmar, where local official Jean Fakhry said authorities were struggling to cover even a fraction of needs and some people had spent the night in their cars.

“We cannot continue this way,“ he said.

The killing of six Lebanese health workers and wounding of four others in three separate strikes across south Lebanon on Thursday brought the total toll of health workers killed and wounded in over a year of Israeli strikes to 178 and 279 respectively, the Lebanese health ministry said.

Hezbollah said it had launched several rocket and artillery attacks against Israeli forces near the southern town of Khiyam on Thursday. It marked the fourth straight day of fighting in and around the strategic hilltop town, which is home to one of the largest Shi’ite communities in southern Lebanon.

Hezbollah aims to keep Israeli forces out of the town to prevent them detonating homes and buildings, as has happened on a large scale in other border towns, a source familiar with the group’s thinking told Reuters.

Hezbollah says its fighters have prevented Israel from fully occupying or controlling any southern villages, while Israel says it is carrying out limited ground operations aimed at destroying the group’s infrastructure.

The White House said on Wednesday U.S. security official Brett McGurk would visit Israel on Thursday along with Amos Hochstein, a U.S. envoy who has sought to broker a ceasefire between Israel and Hezbollah.

A U.S. official said they would discuss a range of issues “including Gaza, Lebanon, hostages, Iran and broader regional matters” during the visit.

Sources previously told Reuters talks were centred on a 60-day pause to allow for the implementation of U.N. Security Council Resolution 1701, which would entail Hezbollah withdrawing its armed presence from south of the Litani River. (Reporting by Laila Bassam, Timour Azhari and Maya Gebeily in Beirut and Emily Rose in Jerusalem; Editing by Alex Richardson, Gareth Jones, Philippa Fletcher)