PHOTO: GENT SHKULLAKU/AFP via Getty Images

TOPSHOT - Emergency workers clear debris at a damaged building in Thumane, 34 kilometres (about 20 miles) northwest of capital Tirana, after an earthquake hit Albania, on November 26, 2019. - Four people died and some 150 were slightly injured in Albania after a 6.4 magnitude earthquake, the strongest in decades, rocked the Balkan country early Tuesday. The epicentre of the quake was about 34 kilometres (about 20 miles) northwest of Tirana, according to the European-Mediterranean Seismological Centre. (Photo by Gent SHKULLAKU / AFP) (Photo by GENT SHKULLAKU/AFP via Getty Images)

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(CNN) —

At least 23 people have been killed, several more are missing and hundreds have been injured after an earthquake struck Albania on Tuesday.

The quake, which had a preliminary rating of 6.4 magnitude, hit the European nation at an approximate depth of 20 kilometers (12 miles) early Tuesday local time, according to the United States Geological Survey. It is the strongest to hit Albania in 40 years.

The epicenter was in the port city of Durres, about 36 kilometers (22 miles) from the capital Tirana. Social media videos from the area show several buildings have collapsed.

Albanian Prime Minister Edi Rama’s office revised the death toll upwards several times on Tuesday. At least four victims died in Durres, spokesman Endri Fuga told CNN. Another two died in Thumane, one person died after jumping from a building in panic in Kurbin, and one victim died while driving on a badly damaged road in Lezhe, the spokesperson added.

Around 45 people were rescued from the rubble, Fuga told CNN, and more than 650 people have received medical attention throughout the day. He added that 30 people are being treated in hospitals.

Fuga did not want to speculate on how many people may still be missing, but added that search and rescue teams would continue working throughout the night in the affected areas.

Nearby Bosnia and Herzegovina was also struck by an earthquake on Tuesday morning, the country’s interior ministry told CNN. That quake had a 5.4 magnitude rating.