Rescue teams continue to make their way to remote villages in central Italy as the death toll rises after a powerful earthquake rocked the region, collapsing homes as their residents slept.

Italian Prime Minister Matteo Renzi announced early on Thursday morning that 120 people have died.

But ABC reported about 7.45am AEST that the toll had risen to at least 159.

The magnitude 6.2 quake struck at 11.36am Wednesday (AEST) and was felt from the Lazio region into Umbria and Le Marche on the Adriatic coast.

At least 73 people were confirmed dead overnight and 150 missing, before the toll leapt again.  The hardest-hit towns included Amatrice, Accumoli and Pescara del Tronto some 100km northeast of Rome.

“The town isn’t here anymore,” said Amatrice mayor Sergio Pirozzi.

The Department of Foreign Affairs said it was making “urgent enquiries” to determine if any Australians were affected. 

Residents in the Italian capital Rome reported feeling a long swaying followed by aftershocks.

The BBC’s James Reynolds reported from Amatrice that sniffer dogs were being sent into buildings to search for survivors and local authorities were trying to assess the number of people missing.

Rocks and metal tumbled onto the streets and dazed residents huddled in piazzas as an estimated 39 aftershocks continued into the early morning hours, some as strong as 5.1.

The first two confirmed victims were an elderly couple whose home collapsed in Pescara del Tronto in the Marche region, according to local police. 

Rescuers work frantically to free victims. Photo: Getty

Daylight shows true horror

As daylight dawned, residents, civil protection workers and even priests began digging out with shovels, bulldozers and their bare hands, trying to reach survivors. There was relief as a woman was pulled out alive 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 told AP.

Italy’s national blood drive association appealed for donations to Rieti’s hospital.

“Now that daylight has come, we see that the situation is even more dreadful than we feared with buildings collapsed, people trapped under the rubble and no sound of life,” Accumoli mayor Stefano Petrucci said.

A man is pulled from the rubble of his former home in Amatrice. Photo: AP/AAP

In Accumoli, to the north of Amatrice, many people were feared dead.

“There is a family of four under a collapsed house and sadly there are two small children among them,” Mayor Stefano Petrucci said.

Rescuers digging with bare hands

A local photographer told reporters of 15 rescuers digging with their bare hands trying reach the family.

“They can hear the screams of the mum and one of the children,” he said.

Their efforts proved fruitless – all four have died.

Two neighbours embrace next to collapsed houses in Pescara del Tronto. Photo: AP/AAP

Italian President Sergio Mattarella has described the disaster as “a moment of grief and of appeal to shared responsibility”.

The devastation is reminiscent of the 2009 quake that killed more than 300 people in and around the town of L’Aquila, which sent emergency teams on Wednesday to help with the latest tragedy.

Amatrice @SkyTG24 pic.twitter.com/JElPrnDzd7

— flavio maccarone (@magar81) August 24, 2016

Pope holds prayer service

Pope Francis turned his regular St Peters square audience into a prayer service on Wednesday.

“Hearing the news of the earthquake that has struck central Italy and devastated entire areas, leaving many dead and wounded, I cannot fail to express my heartfelt sorrow,” the Pope said.

“Having heard the mayor of Amatrice say, ‘The town no longer exists’, and knowing that there are children among the dead, I am deeply saddened,” he added.

The Vatican has dispatched six of its firefighters to Amatrice to help civil protection workers look for survivors.

The mammoth task of the rescue effort in Pescara del Tronto. Photo: AP/AAP

The Italian geological service put the magnitude at 6.0 while the US Geological Survey reported 6.2 with the epicentre at Norcia, about 170km northeast of Rome, and with a relatively shallow depth of 10km.

The central Italian town of Amatrice.

– with agencies