At least seven people were killed when the most powerful earthquake to hit Albania in decades rocked the capital Tirana and surrounding region early on Tuesday, causing buildings to collapse and burying residents under rubble.
Residents, some carrying babies, fled apartment buildings in the capital Tirana after the 6.4 magnitude quake struck shortly before 4 a.m. (0300 GMT).
In the nearby northen town of Thumane, Marjana Gjoka, 48, was sleeping in her apartment on the fourth floor of a five-storey building when the quake shattered the two top floors.
"The roof collapsed on our head and I don't know how we escaped. God helped us," said Gjoka, whose three-year-old niece was among four people in the apartment when the quake struck.
The quake was centred 30 km (19 miles) west of Tirana, at a shallow depth of 10 km (6 miles), the U.S. Geological Survey (USGS) said, and was also felt across the Balkans and in the southern Italian region of Puglia.
Two women were found dead in the rubble of an apartment building in the northern town of Thumane, and a man died in the town of Kurbin after panicking and jumping out of a building, a Defence Ministry spokeswoman said.
The bodies of three other people were pulled from the wreckage of two collapsed buildings in Durres, the defence ministry said, and a man died near the northern town of Lezhe.
Firefighters, police and civilians were removing the debris from collapsed buildings that had trapped people in Thumane. Most of the buildings that collapsed were built of bricks, a Reuters reporter said.
Rescuers in Thumane used a mechanical digger to claw at collapsed masonry and remove a tangle of metal and cables. Others groped with bare hands to clear rubble.
Two people were pulled out from rubble in Thumane four hours after the quake, a Reuters reporter on the site said. Doctors said they were in bad condition.
"Everything at home kept falling down," Refik, a Tirana resident, said of the impact on his sixth-floor apartment.
"We were awake because of the previous quakes, but the last one shook us around," he told Reuters, referring to several smaller tremors recorded in the hour before the main quake.
Emergency workers told local media one of those killed was an elderly woman who had saved her grandson by cradling him with her body.
The quake was the second powerful tremor to hit the region in two months.
"Firefighters and army staff are helping residents under the rubble", in Durres and Thumane, the Defence Ministry said.
An unidentified man, with a wound dressing on his right cheek, told News24 TV his daughter and niece were among those trapped in a collapsed apartment building in Durres.
"I talked with my daughter and niece on the phone. They said they are well and are waiting for the rescue. Could not talk to my wife. There are other families, but I could not talk to them," the man said.
Three hours after the main tremor, a strong aftershock rocked Tirana.
Located along the Adriatic and Ionian Seas, between Greece and Macedonia, Albania experiences regular seismic activity.
An earthquake of 5.6 magnitude shook the country on Sept. 21, damaging around 500 houses and destroying some. The Defence Ministry had said it was the most powerful quake in Albania in the last 30 years.
The images of collapsed or semi-collapsed buildings in urban areas suggested Tuesday's quake was more powerful than one in 1979 which razed a neighbourhood of a northern town. Neither of those two earlier earthquakes caused any fatalities.
The Balkan nation is the poorest country in Europe, with an average income of less than a third of the European Union average, according to Eurostat data.