At least 247 people were killed after a 6.2-magnitude earthquake struck central Italy Wednesday, according to Italy's Civil Protection Department.
In the small Italian towns hit hard by a magnitude-6.2 earthquake that struck in the middle of the night, rescuers feverishly dug through the rubble of downed homes and apartments looking for survivors.
In one such rescue, shown on CNN affiliate Sky TG24, a firefighter in Amatrice clawed at the rubble, trying to get to a little girl.
He pulled back bricks and other debris as his co-workers and other men leaned in.
Suddenly there was a foot, and leg, then the other leg.
In the video, a man seems to be talking to the girl, as someone repeatedly says the name "Julia."
Several people wriggle in to help the firefighter.
The firefighter clutches a girl, said to be 8 years old, and walks her out of the huge pile of rubble as a volley of cheers erupts.
The girl silently holds on. It is impossible to tell what color clothes she is wearing because she is coated in gray dust.
"Bella ragazza!" one bystander says as the girl is carried to safety. "Beautiful girl!"
Similar scenes played out in Amatrice and the other towns hit hardest by the deadly quake, which killed at least 159 people, according to ANSA, Italy's national news agency.
The powerful earthquake hit 10 kilometers (6.2 miles) southeast of Norcia at 3:36 a.m. (9:36 p.m. Tuesday ET).
Italy's Civil Protection agency said of the people killed in the quake, at least 53 of them were in the town of Amatrice, and at least 100 people were injured. Other fatalities were reported in the nearby towns of Accumoli and Arquata del Tronto.
More than 1,000 people have been displaced by the quake, and the Civil Protection agency said no residents will be allowed to sleep in the devastated town of Amatrice Wednesday night.
"Right now we feel terrible pain," Italian Prime Minister Matteo Renzi said after touring some of the affected areas. "Italy is a family that has been hit and struck, but we are not going to be stopped."
Addressing the nation Wednesday, Renzi vowed to spare no effort in the critical window following the quake when lives could still be saved.
"In difficult times, Italy knows what to do," he said.
The death toll is expected to rise as rescue teams work through the rubble, with regular aftershocks posing a continuing threat.
In the village of Saletta, a settlement of about 20 people, residents used their bare hands to ferret through the rubble of a two-story home in a desperate search for neighbors.
CNN's Barbie Nadeau and her crew escaped injury when a home collapsed behind her in Saletta as she did a Facebook Live session.
Rescue efforts continued through the night, said Luigi D'Angelo, an official with Italy's Civil Protection Department.
"Many cases have shown in the past that even after two days people can be rescued alive," he said. "So we want to continue."
With heavy lifting equipment just starting to reach the isolated village, people used tractors, farm equipment and simple hand tools to break through what was left of old stone villas.
Many settlements are only accessible by small roads, posing a challenge for authorities moving in heavy machinery to the disaster sites.
On a roadside, stunned residents in dust-covered pajamas sought comfort after every aftershock.
Emma Tucker, deputy editor of British newspaper The Times, was in Italy's Marche region, about 85 kilometers from the epicenter, when her house started "trembling, shaking ... an absolutely appalling noise."
"It felt like someone had put a bulldozer over the house and was trying to knock it down," she told CNN.
The powerful jolt was felt as far away as Rome, 100 miles from the epicenter.
"It lasted for at least 30 seconds. The entire hotel was shaking," said Charlotte Smith, coach of Elon University women's basketball team in North Carolina, who was in Rome with her players when the quake hit.
"It was pretty terrifying," she said.
The university released a statement
later, saying the team was headed back to Charlotte, North Carolina.
Amatrice 'is no more,' says mayor
The towns at the epicenter of the quake -- Amatrice, Accumoli and Arquata del Tronto -- are scenes of devastation, with what were once charming three-story buildings pancaked by the disaster.
Much of the houses in the area -- unreinforced brick or concrete frame buildings -- were vulnerable to earthquakes, according to the US Geological Survey, and offered little resistance to the powerful temblor.
Amatrice, a town of about 2,000 people in the north of Italy's Lazio region, is in ruins. But amid the rubble, the town's clock tower stood tall, with the clock stopped at the time the quake struck.
"The town is no more," Mayor Sergio Pirozzi told CNN affiliate Rai.
The towns, situated amid remote, mountainous terrain, are particularly popular in the summer with tourists seeking a scenic getaway from the heat of the city.
Red Cross spokesman Tommaso della Longa said the fluctuating population during the vacation season made it hard to know exactly how many people might be trapped in the debris.
Amatrice, known for its traditional all'amatriciana pasta sauce, had been gearing up to hold a festival celebrating the pork jowl, chili and pecorino recipe
this weekend, with many visitors expected.
Pope calls for prayers
Pope Francis called for prayers for those affected by the disaster while Italian President Sergio Mattarella said "the entire country should rally with solidarity around the affected populations."
"At the moment we need to employ all our forces to save human lives, treat the injured and ensure the best conditions for the people displaced," he said.
President Barack Obama called Mattarella on Wednesday to offer US assistance.
The leaders of France, Germany and Russia all expressed their sympathy over the disaster, while the Italian Voluntary Blood Association made an appeal for people to donate blood to help treat those affected.
Italy is no stranger to deadly quakes.
In May 2012, a pair of earthquakes
killed dozens of people in northern Italy, while in April 2009, a magnitude-6.3 earthquake hit in the Aquila region of central Italy, killing 295. The earthquake Wednesday struck an area close to the 2009 earthquake.
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