Thousands of rescuers have searched through the night for survivors following Wednesday’s earthquake in a mountainous area of central Italy.
More than 240 people have died and at least 368 were injured, officials said.
Many people are still believed to be buried under rubble and more than 4,300 rescuers are using heavy lifting equipment and bare hands to find them.
Many of the victims were children, the health minister said, and there were warnings the toll could rise further.
The search for survivors continued overnight
Early on Thursday, Italy’s civil protection authorities said a total of 247 people were now known to have died, with 190 deaths reported in Rieti province and 57 in neighbouring Ascoli Piceno province.
Among the victims was an 18-month-old toddler, Marisol Piermarini, whose mother Martina Turco survived the deadly 2009 earthquake in L’Aquila and moved away from there after the experience, Italian news agency Ansa reported.
Ms Turco was being treated in hospital after being pulled from the rubble in the village of Arquata del Tronto, Ansa said.
People cover themselves with blankets as they prepare to spend the night in the open following an earthquake in AmatriceImage copyrightREUTERS
Image caption
Amatrice residents spent the night outdoors
Late on Wednesday there were cheers in the village of Pescara del Tronto when a young girl was pulled alive from the rubble after being trapped for 17 hours. Almost all the houses there had collapsed, the mayor said.
The 6.2-magnitude quake hit at 03:36 (01:36 GMT) on Wednesday 100km (65 miles) north-east of Rome.
Hardest hit were the small towns and villages in the mountainous area where the regions of Umbria, Lazio and Le Marche meet.
People there spent the night outside or in tents provided by the emergency services.
These pictures show the main street in Amatrice before and after the quake
A spokeswoman for the Italian Red Cross told the BBC that the area had been shaken by aftershocks.
The mayor of the historic town of Amatrice said three-quarters of the town had been destroyed and no building was safe for habitation.
These images show the hamlet of Pescara del Tronto before and after
Many of those affected were on holiday in the region. Some were in Amatrice for a festival to celebrate a famous local speciality – amatriciana bacon and tomato sauce.
The country is no stranger to earthquakes: the 2009 L’Aquila tremor killed more than 300 people and in May 2012 two tremors nine days apart killed more than 20 people in the northern Emilia Romagna region.
Source: Ittefaq