Rescuers pause in Amatrice, central Italy, where a 6.1 earthquake struck just after 3:30 a.m., Wednesday, Aug. 24, 2016. The quake was felt across a broad section of central Italy, including the capital Rome where people in homes in the historic center felt a long swaying followed by aftershocks. (AP Photo/Emilio Fraile)
Rescuers search for survivors in Amatrice © AP

The search continued on Thursday for survivors of the devastating earthquake that struck a series of towns and villages across central Italy, with authorities saying that 250 people were now confirmed dead.

Some 365 injured remained in hospital, a day after the magnitude 6.2 quake flattened the towns of Amatrice, Accumoli and Pescara del Tronto.

Dozens of people are believed to still be trapped in the rubble. Rescue efforts had continued by torchlight throughout the night in the hilltop towns close to the epicentre that have also been left without water or electricity.

More than 900 firefighters, who used heavy-lifting equipment and their bare hands to search for survivors of the rubble of centuries-old buildings, were hit by a wave of strong aftershocks. Rescuers did manage to save a 10-year-old girl, pulling her alive from the rubble where she had lain for 17 hours in Pescara del Tronto.

Matteo Renzi, the prime minister who had visited the worst-hit areas on Wednesday, declared a state of emergency and said that the cabinet would meet to decide measures to help the affected communities. There are fears that the death toll could rise further.

Rescue efforts have been complicated by a lack of clarity on the number of people in the area, a sleepy region that sees its population swelled by tourists in the summer.

“In the winter we are no more than 100 people but there are three, four times that amount in the summer,” Aleandro Petrucci, mayor of Arquata del Tronto, told Italian television.

In Amatrice, voted one of Italy’s most beautiful historic towns, aerial photographs showed whole areas flattened by the quake. Emergency workers in the town said that they had pulled back from a local hotel amid fear of further collapse as aftershocks registering as much as 4.3 rocked the area, sending survivors screaming and crying for help, according to eyewitnesses.

Sergio Pirozzi, the town’s mayor, had said he believed that 70 tourists were in the Hotel Roma before the quake. Officials on Thursday reduced that number to about 35, saying that many had escaped after the first shock.

Rescuers search through debris following an earthquake in Pescara Del Tronto, Italy, Wednesday, Aug. 24, 2016. The magnitude 6 quake struck at 3:36 a.m. (0136 GMT) and was felt across a broad swath of central Italy, including Rome where residents of the capital felt a long swaying followed by aftershocks. (AP Photo/Andrew Medichini)
Dozens of people are believed to still be trapped under collapsed buildings © AP

Town officials had expected Amatrice’s population of 2,600 to increase as much as tenfold this weekend when the town was due to hold a festival to celebrate its local Amatriciana pasta dish.

Among the visitors for the food festival was Marco Santarelli, a 28-year-old chef who was staying with his grandparents. Local papers reported that Mr Santarelli’s father, Filippo, had dug his dead son out of the rubble of the family home with his bare hands, having driven from Rome to find him after the quake hit. Marco had failed to answer his mobile phone.

Mr Renzi pledged to give the area “certainty on the timeline for reconstruction”, in what was seen as an attempt to draw a line under Italy’s poor handling of past natural disasters.

Earthquake strikes Italy

After Italy’s previous major earthquake, in l’Aquila in 2009, in which more than 300 people died, botched rescue efforts left many people homeless for months, and organised crime infiltrated the reconstruction efforts.

The handling of the crisis contributed to the plunging popularity of then prime minister Silvio Berlusconi, who suggested displaced survivors should consider themselves in “holiday camps”.

Most of the damage from the quake was in the Lazio and Le Marche regions, with Lazio bearing the brunt of the damage and the biggest toll.

Neighbouring Umbria was also affected. All three regions are dotted with centuries-old buildings vulnerable to earth tremors.

Wednesday’s quake was relatively shallow at 4km below the earth’s surface. INGV, Italy’s earthquake institute, reported 150 aftershocks in the 12 hours following the initial tremor, the strongest measuring 5.5.

Italy sits on two faultlines, making it one of the European countries most exposed to seismic activity. One of the faultlines runs north to south along the spine of the Apennine mountains. The other spans east to west south of Rome and north of Naples.

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