At least 21 people have been killed in the most powerful earthquake to hit Albania in decades, 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 4am on Tuesday.
In the 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 top floors.
"The roof collapsed on our head and I don't know how we escaped. God helped us," said Ms Gjoka, whose three-year-old niece was among four people in the apartment when the quake struck.
The quake was centred 30km west of Tirana, the US Geological Survey said, and was also felt across the Balkans and in the southern Italian region of Puglia.
Some 42 people have been rescued alive in efforts that continued after the sun went down with headlamps and spotlights.
Dulejman Kolaveri, a man in his 50s in Thumane, told AFP he feared his 70-year-old mother and six-year-old niece were trapped inside the five-storey apartment, because they lived on the top floor.
"I don't know if they are dead or alive. I'm afraid of their fate... only God knows," he said with trembling hands.
Two women were found dead in the rubble of an apartment building in the northern Albanian town of Thumane and a man died in the town of Kurbin after jumping out of a building, a Defence Ministry spokeswoman said. Another body was recovered from rubble in Thumane.
Four bodies were pulled from two collapsed buildings in the western town of Durres, the Defence Ministry said, and a man died near the northern town of Lezhe.
Defence Minister Olta Xhacka said 135 people were injured.
Firefighters, police and civilians were removing the debris from collapsed buildings 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 from rubble in Thumane four hours after the quake, a Reuters reporter said. Doctors said they were in a bad condition.
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.
Two planes from fellow NATO-member Romania were expected to land with specialised search and rescue equipment and help was coming from Italy and Turkey, Ms Xhacka said.
"Firefighters and army staff are helping residents under the rubble", in Durres and Thumane, the Defence Ministry said.
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 September 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.
