ROME — At least 250 people were killed and dozens more were missing or feared dead Wednesday after a magnitude 6.2 earthquake and a series of aftershocks struck several towns in central Italy, according to Italy's civil protection agency.

Italy’s civil protection agency, revising downward an earlier death toll, said early Thursday that at least 250 people were killed and at least 365 others hospitalized.

Most of the dead were in Amatrice, a picturesque medieval town of around 3,000 people.

The search efforts are focused around the isolated hilltop communities of Amatrice, Accumoli and Pescara del Tronto where sniffer dogs, firefighters and paramedics were desperately searching for signs of life amid huge chunks of rock, cement and metal from collapsed homes and buildings.

Thousands of rescuers are using heavy lifting equipment to sift through the rubble but many are also using their bare hands.

In Pescara del Tronto, firefighters plucked an 8-year-old girl named Giorgia from the rubble where she had been trapped for 16 hours. Rescuers said they were able to locate the area of Giorgia's room and started digging until they reached her. They also found the body of her sister, who was lying next to her, Italian news agency ANSA reported.

The search for life went on as aftershocks rattled the area a day after the magnitude-6.2 quake struck at around 3:30 a.m. local time Wednesday. As many as 470 aftershocks have been recorded since the initial jolt, ANSA reported.

Police near the town of Ascoli said they could hear cries for help from under the rubble but lack the heavy equipment to move the rocks, according to the RAI radio.

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“Half of the town doesn’t exist anymore,” Sergio Perozzi, mayor of Amatrice, told RAI-TV. “People are stuck underneath the rubble. Houses are no longer there.”

Several buildings collapsed and lights went out after the earthquake, Perozzi said. He said he had trouble communicating with emergency responders and couldn't reach the hospital. The center of Amatrcie was devastated and homes collapsed on residents as they slept.

“The whole ceiling fell but did not hit me,” resident Maria Gianni told the Associated Press. “I just managed to put a pillow on my head and I wasn’t hit luckily, just slightly injured my leg.”

The picturesque medieval town of about 3,000 residents — best known as the home of “pasta all’amatriciana” — is remote and was cut off after a bridge connecting the town and the rest of the region was damaged in the quake.

Search parties sifted through the rubble in various towns and villages as the sun rose. It became clear for some officials that the extent of the damage was worse than they initially thought.

"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," Pertucci, Accumoli mayor, told RAI-TV.

Fabrizio Curcio, the director of Italy’s civil protection agency, activated national emergency procedures. He said the quake was on par with one in L'Aquilla in 2009 that left more than 300 people dead.

The first earthquake struck around 3:30 a.m. local time near Norcia, a small town roughly 105 miles from Rome, according to the U.S. Geological Survey. No victims were reported there, but the quakes damaged buildings, according to RaiNews24.

“Much of our patrimony is damaged, but there are no victims,” Mayor Nicola Alemanno told RaiNews24. “That is the good news.”

Recent Large Earthquakes in Italy | FindTheData

The first quake was followed by at least 11 tremors in what the seismological center described as a “high aftershock rate.”

"Aftershock rate is high in #Italy following M6.2 and will likely continue in the coming days," the center said in a tweet Wednesday.

The U.S. Embassy restricted all but essential official travel to the area and recommended that U.S. citizens defer travel in these areas as well.

In Rome, residents said they felt a long swaying followed by aftershocks.

“I could feel the ground shake and my three dogs started to go a little crazy, running around and barking," Maurizio Serra, 56, told USA TODAY. "I could hear other dogs in other apartments."

Serra, who lives on the fourth floor of a Renaissance-era building in the historical center of Rome, said he felt a couple of smaller quakes afterward.

"Thank God there was no serious damage in our building,” he said.

Fatalities from Earthquakes in Italy | Graphiq

Facebook issued a safety check for those potentially affected by the quake.

The Italian earthquake institute (INGV) reported 60 aftershocks in the four hours following the first quake, the strongest at 5.5.

Since Italy sits on two fault lines, it has gained a reputation as one of the most earthquake-prone countries throughout Europe.

The 2009, 6.3-magnitude earthquake in L'Aquila occurred roughly 55 miles south of the latest tremor.

The most deadly earthquake since the 20th century struck in 1908, when a quake followed by a tsunami killed about 80,000 people in Reggio Calabria and Sicily.

Steph Solis reported from McLean, Va.; Contributing: Charles Ventura from Los Angeles, Jessica Durando from McLean.