At least 51 people have died after the most powerful earthquake to hit Albania in decades jostled the capital, Tirana, and its heavily-populated surrounding region, causing several buildings to collapse and burying residents in the rubble.
The magnitude-6.4 quake struck shortly before 4am local time (03:00 GMT) on Tuesday, the United States Geological Survey (USGS) said. It was the second powerful tremor to hit the region in two months.
Tuesday's earthquake was centred 30km (19 miles) west of Tirana, at a shallow depth of 10km (six miles), according to the USGS."Ten more victims were found during the night, bringing the number of dead to 40," the ministry said in a statement.
With the help of experts flown in from across Europe, rescuers have been working tirelessly to clear away the debris of collapsed apartments and hotels in the coastal city of Durres and the town of Thumane, the two areas hardest hit by the earthquake.
Forty-six people have been pulled out alive so far and have been hospitalised, the defence ministry spokeswoman told AFP news agency.
The number of people who may still be buried under the rubble is unknown.
Hundreds of aftershocks have continued to rattle the country, sparking panic and temporarily halting search efforts.
Among some 650 who were injured, at least 10 are seriously wounded, the health ministry said.
Thousands have been displaced, either because their homes were severely damaged or because it is still unsafe to return home because of the aftershocks.
Two women were found in the rubble of an apartment building in the northern village of Thumane, and a man died in the town of Kurbin after jumping out of a building, Albana Qehajaj, a defence ministry spokeswoman, said.
The bodies of three other victims were pulled from the wreckage of two collapsed buildings in the western city of Durres, Qehajaj added.
At least 150 people wounded during the earthquake were being treated in hospitals in Tirana and Durres, Health Minister Ogerta Manastirliu said.
Albania's Prime Minister Edi Rama said on Tuesday that neighbouring countries, the European Union and the United States had all offered immediate support.
Rama added that neighbouring Kosovo was sending an emergency team.
'Dramatic situation'
A Reuters news agency witness described residents fleeing apartment buildings in Tirana, some carrying babies. Power was down in several neighbourhoods.
Three hours after the main overnight tremor, a strong aftershock rocked the city
Several smaller tremors were recorded in the hour before the main quake, which was also felt in several neighbouring countries and beyond, including in the southern Italian region of Puglia.
"We were awake because of the previous quakes, but the last one shook us around. Everything at home kept falling down," Refik, a Tirana resident, told Reuters of what happened in his sixth-floor apartment.President Ilir Meta meanwhile told journalists in Thumane that "all efforts" were being made to "take the people out of the ruins".
Footage posted on social media purportedly showed people in the village attempting to clear away mounds of rubble.Besar Likmeta, a journalist for the BIRN Albania non-governmental media organisation, described the damage caused across central Albania by the earthquake as "extensive".
"It is a very densely populated area that has been affected; the triangle between the city of Durres and Tirana is the most populated area in Albania, where one-third of the population lives," Likmeta told Al Jazeera from Tirana.
"The fear is that the casualty figures will rise, but people are still hoping for miracles and the work to save as many people as possible is continuing."
A magnitude-5.6 earthquake shook Albania on September 21, damaging around 500 houses, some of which were completely destroyed. The defence ministry had said at the time it was the most powerful quake to hit the country in the past 30 years.
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Earthquake