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A powerful aftershock has hit central Italy, nearly two days after a major earthquake caused severe damage.
The 5.5-magnitude tremor brought down masonry from already damaged buildings and was felt as far away as Rome.
Rescuers are continuing into the night their search for victims trapped in the rubble from Monday's earthquake.
Hope remains that more people will be found alive, as Italian media reported that a woman had been found 42 hours after the quake.
The woman, named Eleonora, was said to be conscious throughout the operation to rescue her from the debris of a building close to the historic centre of the city of L'Aquila.
Earlier Italian Prime Minister Silvio Berlusconi said the operation would continue for a further 48 hours and involve 7,000 rescuers.
Rescuers said they needed to get results quickly to prevent further problems for those affected.
"We're a bit tired," Fabrizio Curcio, director of the civil protection emergency bureau told AFP news agency.
"But frankly, fatigue is not a major concern... We're running on adrenaline. There's still a long road ahead of us."
More than 200 people were killed and more than 1,000 injured. One-hundred-and-fifty people have been pulled alive from the rubble.
The head of the Italian Red Cross, Francesco Rocha, said 20,000 people were homeless and it could be months or even years before they were all back in their own homes.
More than 10,000 buildings have been destroyed - mostly in L'Aquila.
As rescue efforts continued:
A 98-year-old woman was pulled out alive in L'Aquila after being trapped for 30 hours, local media report. She spent the time crocheting
Four students have been located in a collapsed university hall of residence, but remain trapped under large chunks of masonry, the Associated Press reports. It is not known whether they are alive or dead
A 23-year-old student was pulled alive with the help of specialist cavers from the rubble of a four-storey building in L'Aquila more than 22 hours after the quake struck
L'Aquila and the surrounding area were without water
Serious risks
Latest from Dominic Hughes in Fossa, a village near L'Aquila
Successes are becoming rarer. At two o'clock this morning a woman was rescued by a team of expert cavers after a long and painstaking operation to remove huge slabs of concrete. But with every passing hour the likelihood of finding survivors is reduced. Apart from the search for survivors the most urgent task is to find some kind of accommodation for thousands of people who are now unable to return to their damaged homes.
Earlier Mr Berlusconi, appearing at a news conference in L'Aquila, thanked all involved in the rescue effort.
"There have been serious risks for the lives of those who are carrying out the rescue operation so far, inside buildings that have been damaged and, following another tremor, could easily collapse," he said.
"So therefore this is a very dangerous situation for the rescuers."
He said that starting from Wednesday specialists would start checking individual buildings.
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Mr Berlusconi has refused foreign aid, saying Italians were "proud people" and had sufficient resources to deal with the crisis.
But AFP news agency quoted him as saying he could accept funds from Washington to help restore historical buildings.
Between 3,000 and 10,000 buildings are thought to have been damaged in L'Aquila, making the 13th-Century city of 70,000 uninhabitable for some time.
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An aftershock with a magnitude of 5.6 shook Central Italy on Tuesday, nearly 48 hours after a major 6.3 quake hit the country.  Earlier in the day, another aftershock of 4.2 was also reported.  The death toll from the quakes has now surpassed 200 with thousands of others injured.  At least one person was killed in the aftershock.

The aftershock caused two apartment blocks to collapse in the city of L'Aquila, and slabs of masonry fell from other damaged buildings. Local media reported that an old church and many houses were also damaged. The shaking was felt as far away as Rome.

Francessco Rocha, the head of the Italian Red Cross, estimated that 20,000 people had lost their homes, and it may be many months before they can return to them.

"The victims so far are 207," said the premier of Italy, Silvio Berlusconi, at a press conference. "Of these victims, 190 have been identified while other 17 remain unidentified, 15 people are missing and there are more than 1,000 injured, 100 of which are in serious conditions," said Rocha.

"Civil protection men are working hard and for the next 48 hours rescuers will search for other survivors," added Berlusconi. "More than 7,000 men are at work. These people risk their lives and I want to congratulate myself with them, they are doing an extraordinary job considering the frequent ground movements complicate rescuing operations. Already 150 people have been extracted and saved from the ruins."

The 6.3-magnitude quake on April 6 is the deadliest quake to strike Italy since November 23, 1980. Nearly 3,000 people were killed in a magnitude 6.8 earthquake that struck Southern Italy in the Irpinia region. At least 10,000 were injured in that earthquake, with over 300,000 being left homeless.