The October 7 forensic DNA identification operation: Lessons learned from the management of the largest mass causality event in Israel

On October 7, 2023, the Hamas terrorist organization launched a surprise, violent attack on Israel, resulting in the largest mass casualty event in the country's history. A total of 1438 Israelis were murdered, and 255 individuals were taken hostage. Additionally, over 1600 perpetrators who infiltrated Israel were killed during defensive operations. The scale of the massacre, number of victims, severity of body damage, and sheer volume of remains posed an unprecedented forensic challenge. The Israel Defense Forces (IDF), Israel Police, and the National Center for Forensic Medicine led a multi-agency effort to identify the deceased. With thousands of remains from both victims and perpetrators intermingled, DNA played a pivotal role in the identification process. Between October and December 2023, forensic teams analyzed 4500 tissue samples, 630 bone samples, and 2600 reference samples, with all genetic profiles uploaded to the national DNA database for matching. The efficiency of this forensic operation is reflected in the 96% identification rate achieved within 3 weeks. However, the condition of the remains significantly impacted the complexity of the process, as severely burned and fragmented samples required multiple rounds of sampling and repeated DNA extractions to obtain viable genetic profiles. This article presents key lessons learned from managing DNA identification in the aftermath of October 7. It highlights the unique challenges faced and outlines strategies for effectively navigating mass casualty events. Our experience offers guidance for forensic agencies worldwide, aiming to enhance and refine DNA identification processes for handling complex Disaster Victim Identification (DVI) operations.