A powerful earthquake hit central Italy in the middle of the night, destroying small mountain towns and burying victims in the rubble of collapsed buildings. At least 63 people were killed, Italian news agency Ansa said.

The quake struck at 3:36 a.m., the Civil Protection agency said in a statement Wednesday. The death toll continued to climb throughout the day as rescuers search for survivors and bodies amid the debris in the regions of Lazio, Umbria and Marche.

“Everything collapsed, there was just dust, and now there’s nothing there,” said Silvia, a young woman standing on the side of the road in the hard-hit village of Amatrice, who declined to give her last name.

The 6.0-magnitude tremor hit at a depth of 4 kilometers (2.5 miles) around 43 kilometers from the town of Rieti, according to the Italian Institute of Geology and Vulcanology. Shaking was felt in buildings in Rome and there were a series of aftershocks reported.

Relief efforts were hampered by damage to radio and satellite links, said Civil Protection, which provided a provisional report of at least 38 people confirmed dead as of midday. News agency Ansa later provided an updated report of 63 dead, based on information from its correspondents on site.

“We must be equipped for the emergencies of the next few hours, days and weeks, but for now the priority above all is to continue searching through the rubble,” Prime Minister Matteo Renzi said in a televised address. “I will visit the affected area late this afternoon.”

The quake and its aftermath may further complicate Renzi’s efforts to put the country back on a stable economic path. He already is facing a make-or-break referendum on constitutional reform in the autumn.

Italian President

Italian President Sergio Mattarella was in close contact with Civil Protection since the early hours of the morning and returned to Rome from Palermo, Sicily, according to a statement from his office. Lazio’s regional president, Nicola Zingaretti, described the situation as an “incredible catastrophe” and urged people to not to clog the main relief routes.

Sky TG24 television showed images of collapsed buildings throughout the historical center of Amatrice, with a population of about 2,500, around 140 kilometers northeast of Rome. Relief crews and residents were shown searching through the rubble as injured victims were taken away in stretchers.

The road leading to Amatrice was filled with cracks and littered with boulders as people, some still in their pajamas, were still streaming away from the worst-hit areas at mid-morning. In the village of Pescara del Tronto, at least 100 people were missing, Sky quoted news agency AGI as saying. Television pictures showed an almost completely collapsed village center. At least one child was rescued from the rubble.

“The houses are gone and people are under, there are likely dead,” Amatrice Mayor Sergio Pirozzi told Sky. “Please help us, the roads are closed, please.”

The mayor of Accumoli, Stefano Petrucci, told RAI at least four people — a family with two children — were trapped under rubble there and the town had no power. At least one person was killed, he said.

An earthquake in 2009 killed more than 300 people near the city of L’Aquila, about 113 kilometers southeast of Amatrice. Those tremors, the country’s deadliest in almost three decades, damaged thousands of buildings in and around the medieval city of L’Aquila and caused billions of euros in damage.