The death toll has risen to at least 241 in the earthquake in Umbria, with dozens more people believed to be trapped under rubble.
Rescuers continued to search through the night for survivors in mountain villages in central Italy, including Amatrice, Accumoli and Pescara del Tronto.
Five bodies have been pulled from the ruins of the Hotel Roma in the historic town of Amatrice, where most guests had managed to escape.
But 10 people staying at the historic hotel are still unaccounted for.
The 6.2-magnitude quake struck 65 miles north-east of Rome in the early hours of Wednesday when people slept in their beds.
Italy’s health minister said many of the victims were children and warned the death toll could rise further.
Many affected were on holiday in the region and some were attending a food festival in Amatrice.
The mayor of Amatrice said three-quarters of the town had been destroyed and no building was safe to live in.
The area has also been shaken by strong aftershocks.
Meanwhile, a second quake has struck northern Italy, killing at least 16 people and injuring 200 others.
The magnitude 5.8 quake hit the Emilia Romagna region, which had suffered an earthquake in May of this year and had left many residents still living in tents.
The towns of Mirandola, Medolla and Cavezzo were closest to the epicentre, but the cities of Milan and Bologna were also shaken.
