Residents of a quake-struck area of northeast Italy have spent the night in their cars, tents and in school gyms in fear of aftershocks after a magnitude 6.0 earthquake killed seven people.

Steady rain fell Monday as residents awoke north of Bologna, the day after the strongest quake in hundreds of years hit the area. A majestic clock tower was knocked down and other centuries-old buildings toppled.

Civil protection officials set up tent camps in soccer fields to house some of the estimated 3,000 people who were either too afraid or unable to return home.

Resident Donatella Gadda spent the night in her car. She said she was too afraid to sleep at home, even though civil protection officials said it was safe.

The quake struck at 4:04 a.m., with its epicentre about 35 kilometres north of Bologna at a relatively shallow depth of five kilometres, the U.S. Geological Survey said. Civil protection agency official Adriano Gumina described it as the worst quake to hit the region since the 1300s.