At least 159 people have been killed and dozens more are missing after a powerful earthquake struck central Italy, reducing ancient towns to rubble.
The European Mediterranean Seismological Centre said the epicentre was northeast of Rome, near Norcia in Umbria, while the US Geological Survey (USGS) put the magnitude at 6.2.
“It was so strong. It seemed the bed was walking across the room by itself with us on it,” said Lina Mercantini, of Cesalli, Umbria.
As dawn broke, emergency services and residents were scrambling to rescue people trapped under the ruins of razed old buildings, digging with shovels, bulldozers and even their bare hands to reach survivors.
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Dazed and frightened families – some in tears – could be seen huddling in the streets, wrapped in blankets.
Voices could be heard from under the rubble.
Rescuers pulled an eight-year-old girl alive from the earthquake rubble on Wednesday evening.
Several people were reportedly killed in Pescara del Tronto, in the Marche region, to the east of the quake epicentre.
Seventy-five-year-old Rocco Girardi was brought out alive from the carnage in Arquata del Tronto.
Aleandro Petrucci, the village’s mayor, said Pescara was one of “two or three hamlets that have just completely disintegrated”.
A family of four, including two children, were confirmed dead in the commune of Accumoli.
“Now that daylight has come, we see that the situation is even more dreadful than we feared,” said its mayor, Stefano Petrucci.
Sergio Perozzi, mayor of Amatrice, a picturesque town in northern Lazio turned to ruins by the quake, said buildings had collapsed and lights had gone out.
“The town isn’t here anymore,” he said. “There are voices under the rubble, we have to save the people there.”
There were many fatalities, but images also showed survivors – including a woman and a young girl – being pulled alive from beneath the ruins, and dogs rescued.
At the town’s badly damaged hospital, patients were reportedly being moved out into the streets.
The town’s clock tower stood frozen, showing the moment the deadly quake struck – just after 3.30am local time – while people were asleep.
Sky’s Mark Stone, at the scene, said: “Roads around the area are impassable, so it is problematic getting the right sort of equipment to the right places.”
Agostino Severo, a Rome resident visiting Illica, north of Amatrice, said: “We came out to the piazza and it looked like Dante’s Inferno. People crying for help.”
The tremor was felt across a large swathe of the country, including in Rome, 90 miles away.
Pope Francis led prayers for the dead and missing, saying: “Hearing the mayor of Amatrice say that the town no longer exists and hearing that there are children among the victims, I am deeply saddened.”
In 2009 a 6.3-magnitude earthquake struck in L’Aquila, 55 miles south of the latest quake, killing more than 300 people.