Italy was rocked by another powerful earthquake on Sunday, destroying homes, businesses and ancient buildings.
With a preliminary magnitude of 6.6, it was the strongest earthquake to strike the country in nearly 36 years.
People throughout the mountainous region north-east of Rome were still on edge after a pair of aftershocks last week and an August quake that killed nearly 300.
There were no reports of fatalities in the latest quake, largely due to the fact that thousands had left their homes for shelters and hotels after the earlier tremors.
Despite the new collapses, the head of the civil protection agency, Fabrizio Curcio, said there was no indication that anyone was missing or buried under rubble. Earlier, three people were extracted from rubble in Tolentino.
"These earthquakes are bringing all of central Italy to its knees," Tolentino Mayor Giuseppe Pezzanesi said.
Premier Matteo Renzi pledged that wrecked homes, churches and businesses would rise again, saying they were part of Italy's national identity. The government last week earmarked 40 million euros for rebuilding.
"We will rebuild everything," Mr Renzi said. "We are dealing with marvellous territories, territories of beauty."
Residents already rattled by a constant trembling of the earth rushed into the streets after being roused from bed early on Sunday by the quake. It was felt as far north as Salzburg, Austria, and all the way down the Italian peninsula to the Puglia region.
"It is not since 1980 that we have had to deal with an earthquake of this magnitude," Mr Curcio said, referring to a 6.9-magnitude quake near Naples that killed some 3,000 people in November 1980.
Some 20 people suffered minor injuries. Authorities responded with helicopters to help the injured and monitor collapses, as many roads were blocked by landslides.
Around 3,600 people had already been relocated, many to the coast, following last week's quake, and Mr Curcio said more would follow.
Closest to the epicentre was the ancient city of Norcia, famed for its Benedictine monastery and for the birthplace of St. Benedict, the father of Western monasticism. Witnesses said the 14th century St Benedict Cathedral collapsed in the quake, with only the facade still standing.
"It's as if the whole city fell down," Norcia City Assessor Giuseppina Perla told the ANSA news agency. The city's ancient walls sustained damage, as did another famous Norcia church, St Mary Argentea, known for its 15th century frescoes.
Television images showed nuns rushing into the main piazza as the bell tower appeared on the verge of collapse. Later, nuns and monks knelt in prayer in the main piazza. A firefighter appealed to a priest to help keep residents calm in an effort to prevent them from looking for loved ones.
The town's deputy mayor, Pierluigi Altavilla, said his house remained standing, but everything inside had been toppled.
"It seemed like a bomb exploded inside the house," he told Sky TG24.
The quake came during a long holiday weekend in Italy ahead of Tuesday's All Saint's Day, when Catholics remember the dead. The head of the church in Umbria, Cardinal Gualtiero Bassetti, urged priests not to hold Masses inside churches but in open spaces for fear of further collapses, ANSA reported.
Mayors in some towns, including Castelsantangelo sul Nera, said coffins had been pushed out of their resting place inside cemeteries, which in Italy are typically walled structures.
"The scene is indescribable," Mayor Mauro Falcucci told ANSA.
Basilica of St Benedict in Norcia before and after earthquake Sunday... #terremoto#ItalyEarthquake pic.twitter.com/RSPQCz8UwY— Thomas D. Williams (@tdwilliamsrome) October 30, 2016
The quake struck a cluster of mountain towns, many of historic significance, already reeling from last week's pair of aftershocks to last August's deadly quake, including Visso, Castelsantangelo sul Nero and Preci.
The hilltop town of Camerino sustained new building collapses, but there were no reports of injuries.
The mayor of Ussita said a huge cloud of smoke erupted from the crumbled buildings.
"It's a disaster, a disaster," Mayor Marco Rinaldi told ANSA. "I was sleeping in the car and I saw hell."
In Arquata del Tronto, which had been devastated by the deadly August earthquake, Mayor Aleandro Petrucci said, "There are no towns left."
#ItalyEarthquake: @crocerossa's psychosocial support teams on their way to Visso, central Italy, to assist the local population. https://t.co/UazuVVjMfL— IFRC (@Federation) October 26, 2016
"Everything came down," he said.
The quake sent boulders tumbling onto major roads, forcing closures throughout the quake zone that impeded access to hard-hit cities such as Norcia.
The quake forced the temporary closure of some of Rome's most important tourist sites, including the presidential palace, so authorities could check for damage.
