The latest provisional death toll came as a powerful aftershock struck the hill-side town of Amatrice early on Friday morning, one of the worst-hit areas.

For now at least rescue and emergency teams continue to search for survivors, but in reality their work is now a recovery operation.

Italy’s Civil Protection department says nearly 400 other people remain in hospital – around 40 are said to be in a critical condition.

The Civil Protection Department said Friday the latest provisional death toll from Wednesday's earthquake in central Italy is of 267 dead. Of these, 207 died in the Lazio mountain village of Amatrice, 11 in nearby Accumoli and 49 in the village of Arquata del Tronto, in the neighboring Marche region.

As of yesterday, the fire brigade extracted 215 people from the rubble alive and Alpine rescue services saved 23 lives, to a total of 238. A total of 387 survivors have been hospitalized in the Lazio, Marche and Umbria regions since the August 24 quake, Civil Protection officials said. The department is verifying how many of the injured are still in hospital.

Also on Friday, a 4.8-magnitude tremor occurred at 06:28 in Amatrice, which was largely flattened by the quake that devastated entire villages beginning at 03:36 on Wednesday. The early morning tremor caused more buildings to collapse in the historic center of the village, an ANSA correspondent on the scene reported.

The collapses did not affect fire brigade rescuers at work in two locations along the central village avenue - the Roma Hotel, where a body was extracted last night, and a private residence where two missing children may be trapped. This morning's tremor was followed in the next 15 minutes by eight more, ranging from 2 to 2.8 in magnitude, the National Geophysics Institute (INGV) reported.