More than 4,300 rescue personnel are currently searching Amatrice, Accumoli and Pescara del Tronto where dozens are believed to be trapped following the 6.2-magnitude quake.
Teams searched through the night using heavy lifting machinery as well as their bare hands and have had to contend with a “strong aftershock”, BBC News reports.
The initial quake struck the area, 65 miles north-east of Rome Wednesday morning (August 24).
Many victims were children, the Italian health minister has said – as he warned the death toll could rise further.
Several guests were pulled from the ruins of the Hotel Roma in Amatrice as part of search efforts.
The hotel is believed to have had as many as 70 tourists staying there when the quake hit.
The town’s mayor told reporters that three-quarters of Amatrice had been destroyed.
On Wednesday evening, teams recovered a girl from rubble in the village of Pescara del Tronto after being trapped for 17 hours, BBC News reports.
The earthquake struck a series of small towns and villages in the mountainous area where the regions of Umbria, Lazio and Le Marche meet.
Many of those affected were on holiday in the regions and spent the night in tents provided by the emergency services.
Director of Italy specialist Britaly Travel, Daniele Broccoli told TTG the agency had no clients in the region at the time of the earthquake and had so far received no calls from worried customers holidaying elsewhere in Italy.
Despite the frequency of earthquakes in Italy, Broccoli believed that the tremor would not put tourists off travelling to the country in future.
"The area where the earthquake hit is not really a prime tourist area and is a bit undiscovered," he said. "It’s not like having an earthquake in the heart of Tuscany where perhaps more tourists would be affected.
"In the UK it would be like having a tremor north of Newcastle when you’re holidaying in London - it’s away from where most tourists are.
"It’s incredibly sad seeing the devastation and how many people have died and it’s a blessing for us that none of our passengers were there at the time."
The managing director of Citalia, Stephanie Pritchard added: “While we do not have any customers staying in the towns that have been directly affected, anybody with any concerns or queries should not hesitate to contact our team on 01293 845 354."
