The quake struck at 3:54 a.m. local time and sent panicked residents running out onto the streets of Tirana.

Thumanë, Albania — Albanian rescuers were digging through rubble in search of survivors Tuesday after the strongest earthquake in decades levelled buildings and trapped victims under the debris, claiming at least nine lives and injuring more than 600 people.

The 6.4 magnitude quake struck at 3:54 am local time (0254 GMT), with an epicentre 34 kilometres (about 20 miles) northwest of the capital Tirana in the Adriatic Sea, according to the European-Mediterranean Seismological Centre.

In Tirana, panicked residents ran out on the streets and huddled together in the darkness, an AFP reporter said.

The worst damage was in and around the coastal city of Durres.

Four bodies, including that of a young girl, were pulled from ruins in the port city, where a hotel collapsed and other buildings were badly damaged, the defence ministry said.

Three more bodies were found in rubble in the nearby town of Thumane. In the nearby town of Kurbin, a man is his fifties died after jumping from his building in panic, while another perished in a car accident after the earthquake tore open parts of the road, it said.

The health ministry meanwhile said that more than 600 people received first aid in hospitals.

In Thumane, soldiers, rescuers and families sifted through the rubble of a collapsed five-storey building, with relatives shouting the names of their loved ones: “Mira!”, “Ariela!”, “Selvije!”.

The cries of people trapped inside could be heard as the search was underway, an AFP reporter said.

Thoma Nika, a 58-year-old who lived in the building, said he believed there were at least six people buried under rubble.

Dulejman Kolaveri, a man in his 50s, told AFP he feared his 70-year-old mother and six-year-old niece were trapped, as they lived on the fifth floor of the building.

“I don’t know if they are dead or alive,” he said with trembling hands.

“I’m afraid of their fate… only God knows.”

Arben Allushi, another Thumane local, told AFP with tears in his eyes that his wife and niece were in the building when it fell.

Some 300 soldiers have been sent to Durres and Thumane where “there are people trapped under the rubble”, defence ministry spokeswoman Qahajaj said.

About 1,900 police officers have also been deployed to help.

A man in Durres told local television that his daughter and niece were trapped in the rubble of an apartment building.

“I talked with my daughter and niece on the phone. They said they are well and are waiting for the rescue. I could not talk to my wife. There are other families, but I could not talk to them,” the man said.

Tuesday’s quake was the strongest to hit the Durres region since 1926, seismologist Rrapo Ormeni told local television.

The tremors were felt across the Balkans, from Sarajevo in Bosnia to the Serbian city of Novi Sad almost 700 kilometres away, according to reports in local media and on social networks.

The quake was followed by several aftershocks, including one of 5.3 magnitude, the European-Mediterranean Seismological Centre said. Albanian Authorities described it as the strongest earthquake in the last 20-30 years.

The Balkans is an area prone to seismic activity and earthquakes are frequent.