Rescuers worked into the early hours of Thursday in a desperate search for survivors after a powerful earthquake shook central Italy, leaving at least 159 people dead and devastating several mountain villages.

With 368 people injured, some critically, and an unknown number trapped under rubble, the death toll from Wednesday's pre-dawn quake was expected to rise further, officials warned.

Amid scenes of carnage, dozens of emergency services staff and volunteers were determined to attempt to pluck more survivors from the ruins.

The rescue efforts "won't slow down during the night", the head of the civil protection agency Fabrizio Curcio told public broadcaster Rai, giving an updated toll of 159 dead.

He did not say how many people were still thought to be missing.