Watch: At least 120 killed as quake flattens towns in central Italy

Update 7.55pm - Death toll now stands at 120

Earthquake hit in the early hours of the morning
Rescuers working to save people buried beneath rubble
No Maltese believed to have been affected - hotline set up
'Deeply saddened' Pope prays for victims

The death toll from the earthquake that hit central Italy has risen to 120, Prime Minister Matteo Renzi announced.

Mr Renzi spoke in the provincial capital of Rieti after visiting rescue crews and survivors in the hard-hit town of Amatrice.

He also flew over other demolished towns in the nearby Le Marche region.

Mr Renzi said 34 people had died in Le Marche, the rest from the other towns.

He also said the identification of quake bodies was a difficult process.

An aerial view of the quake damage in Amatrice. Photo: Vigili del Fuoco

The magnitude 6 quake struck at 3.36am local time and was felt across a broad swath of central Italy, including Rome, where residents woke to a long swaying followed by aftershocks.

The centre of Amatrice was devastated, with entire blocks of buildings razed and the air thick with dust and smelling strongly of gas. Amatrice is made up of 69 hamlets that rescue teams were working to reach.

Rocks and metal tumbled onto the streets of the city centre and dazed residents huddled in piazzas as more than 40 aftershocks jolted the region into the early morning hours, some as strong as 5.1.

"The whole ceiling fell but did not hit me," said resident Maria Gianni. "I just managed to put a pillow on my head and I wasn't hit luckily, just slightly injured my leg."

Another woman, sitting in front of her destroyed home with a blanket over her shoulders, said she did not know what had become of her loved ones.

"It was one of the most beautiful towns of Italy and now there's nothing left," she said. "I don't know what we'll do."

Residents, civil protection workers and even priests dug with shovels, bulldozers and their bare hands to reach survivors. Dozens were pulled out alive: There was relief as a woman emerged on a stretcher from one building, followed by a dog.

"We need chainsaws, shears to cut iron bars, and jacks to remove beams: everything, we need everything," civil protection worker Andrea Gentili said. Italy's national blood drive association appealed for donations to Rieti's hospital.

Photo: Reuters/Emiliano Grillotti

People stand along a road following a quake in Amatrice, central Italy. Reuters/Emiliano Grillotti

To the north, in Illica, the response was slower as residents anxiously waited for loved ones to be extracted from the rubble.

"We came out to the piazza, and it looked like Dante's Inferno," said Agostino Severo, a Rome resident visiting Illica. "People crying for help, help. Rescue workers arrived after one hour ... one and a half hours."

The devastation harked back to the 2009 quake that killed more than 300 people in and around L'Aquila, about 55 miles south of the latest quake. The town, which still has not bounced back fully, sent emergency teams on Wednesday to help with the rescue.

A Maltese canine search and rescue team has joined efforts to recover survivors of the powerful earthquake that struck central Italy early this morning.

NO MALTESE REPORTED MISSING

No Maltese are believed to have been affected by the quake at the time of writing, the Foreign Affairs Ministry said in a statement. The Embassy in Rome was in contact with registered Maltese families living in the affected area this morning to offer any assistance if needed, and remains in constant contact with Italian authorities.

Foreign Affairs Minister George Vella expressed his condolences to relatives of the victims and wished all the injured a speedy recovery.

Any Maltese who need help have been urged to contact the Embassy in Rome on +39 348 241 2437 or the Ministry for Foreign Affairs on +356 21242191. People can also email crisis.mfa@gov.mt.

Relatives in Malta of anyone travelling in the region who has not yet contacted home have been urged to contact authorities.