An Albanian boy walks next to tents at a makeshift camp at the soccer stadium in Durres, western Albania, on November 27, 2019, after the strongest earthquake in decades claimed at least 20 lives, with victims trapped in the debris of toppled buildings. (AFP)

Rescue teams in Albania clinged to hope on Thursday of finding missing people in “survival pockets” amid the mountains of rubble wrought by an earthquake that has claimed more than 40 lives.

The 6.4 magnitude quake, the deadliest in decades, tore down buildings near the Adriatic coast while people were sleeping just before 4:00 am (0300 GMT) on Tuesday.

Teams from around Europe have arrived to help shovel away slabs of collapsed apartments and search beneath the wreckage with dogs and specialised cameras.

On Thursday afternoon a new victim was pulled from the ruins of a hotel in the hard-hit port city of Durres, the defence ministry said.

A distraught relative watching the operation fainted as the man’s body was carried away by emergency workers in a yellow bag.

Yet rescuers kept hopes alive for survival stories.

“There may be hope for up to eight or ten days” for victims to live after an earthquake, Captain Joel Leroy, a French rescuer, told AFP.

His team of around 50 was trying to track down two people believed to be trapped inside a seven-storey building in Durres whose first two floors had collapsed into the ground.

Victims may still be alive in “survival pockets” of air that allow them to breathe under the rubble, he said. “That’s why we are working so hard, we believe in it.”

Outside the building a young man with bleary eyes begged to see the body of his mother who was found dead inside. At the moment, rescuers said it was too dangerous to extract her body.

Search efforts have ceased in the other badly damaged town of Thumane, where the defence ministry said no more were missing after more than 20 bodies were pulled out over the last three days.

Loved ones have watched on in horror as rescuers unearth corpses covered in a grey film of dust, many of them relatives still wearing their pyjamas.

During the night, emergency workers in Durres uncovered the bodies of a mother and son from the Reci family, who were found in an embrace.

They were crushed by the weight of a collapsed six-storey building.

The whole Reci family has now perished in the quake, with the bodies of a father and daughter pulled out the day before, according to Ilir Duka, an Albanian rescuer at the scene.

While 42 have been killed, some 50 survivors have been rescued from the rubble, mostly on the first day.

The number of people who may still be buried is unknown.

Emergency workers, including teams from neighbouring Serbia and Kosovo, have been working in perilous conditions as hundreds of aftershocks rattle buildings, interrupting the efforts.

“It’s a difficult operation, but that’s why we’re here, we’ve been doing this for a long time,” said Italian rescuer Michele Melosi, standing with the team’s white-and-brown sniffer dog Folio.

“Hope dies last,” he said, recalling how survivors were found after four days in the 2009 earthquake in the Italian city L’Aquila.

The Italians were searching a flattened four-storey house that belonged to the Lala family and their relatives in a district of Durres that used to be a swamp.

So far there has been only one survivor, a young man pulled out on Tuesday.

A grandmother, child and two other relatives have been found dead, while at least four others are believed to still be inside.

Thousands of people have been displaced, either because their homes were severely damaged or because they were still unsafe due to the continuing aftershocks.

On Wednesday night authorities in Durres moved those who had been sleeping in tents to hotels and a sports centre.

Prime Minister Edi Rama has promised to rehouse the newly homeless by next year.

Illegal construction is rife in Albania, one of Europe’s poorest countries.

Chaotic development exploded after the fall of communism in 1990 and many buildings lack proper permits.

The earthquake was the deadliest in several decades in Albania, which lies near a tectonic fault line.