A powerful earthquake shook Italy's industrial and densely populated northeast early on Sunday, killing at least six people, felling homes and factories and toppling church steeples.
Emergency services said dozens had been injured in the magnitude 6.0 quake, which struck in the middle of the night, sending thousands of people running into the streets in towns and cities across the Emilia Romagna region.
Emergency workers were sifting through the rubble of collapsed buildings for victims, hours after the quake and several aftershocks struck at 730 IST.
Four of the dead were night-shift workers in factories which collapsed, including two who were crushed when the roof of a ceramics factory caved in the town of Sant'Agostino.
A 37-year-old German woman and another woman aged over 100 were reported to have died from shock.
The quake caused "significant damage" to historic buildings as it rattled the cities of Bologna, Ferrara, Verona and Mantua, Italy's culture ministry said.
"According to first reports, damage to the cultural heritage is significant," the ministry said, adding that it was carrying out "more detailed verifications with firemen and the civil protection service."
Italian television showed many historic buildings, including churches, reduced to heaps of rubble. Cars had been crushed under falling masonry, and the Civil Protection Agency had evacuated hundreds of elderly and vulnerable people to makeshift communal shelters in Finale Emilia and towns near the epicentre.
"We were very afraid, all the village went out into the street after the first shock," Umberto Mazza, the mayor of Ostiglia, near Mantua, told the ANSA news agency. "After the second, many took shelter in their cars, but fortunately the damage was fairly limited, above all affecting churches."
Authorities said the quake's epicentre was the commune of Finale Emilia, 36 kilometres north of Bologna, at a depth of only 5.1 kilometres.