Ambulances converged on a market in the Israeli town of Hadera after a bomb went off on Wednesday afternoon.
Civilians had already rushed into the market to aid the many people wounded.
The dead lay scattered around the market and witnesses spoke of body parts hurled far from the scene.
A suicide bomber had detonated a device near a sandwich stand, killing five other people.
As darkness fell, forensic experts were combing the area, checking the bodies of the dead.
Hadera has seen attacks in the past, but suicide bombers had not struck in Israel since August.
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