European and Albanian search teams also have pulled a dead body from the rubble of a hotel along Durres's beach on the Adriatic Sea as they continue looking for survivors of Tuesday's magnitude 6.4 tremor.

There have been more than 500 aftershocks since then, some with a magnitude of more than 5.0, rocking buildings and terrifying residents.

Albania, which marked the 107th anniversary of its independence on Thursday, has not experienced a deadly earthquake since 40 died in a tremor in 1979, and the country is poorly prepared for such disasters.

Italy, Greece, Romania and others have sent search teams to look for survivors.

Under the collapsed four-storey house of Berti Lala, 40, an Italian team found the bodies of his wife, twins and one older son, crushed under a collapsed ceiling as they huddled together in bed.

Lala's paralysed older brother remains trapped under the building, built on reclaimed marshland in Durres, the country's main port.

His other daughter of eight, 79-year-old mother and one niece have all been confirmed killed in the disaster.

But his 17-year-old nephew was rescued alive on Tuesday, apparently saved by a washing machine that moved as the building shook, blocking his path but providing him with enough space for shelter.

In the northern town of Thumane, where 22 people died, searches were halted after the bodies of all those unaccounted for were found, including those of a mother and daughter found embracing each other under the rubble of a five-storey building.

The quake, centred 30km west of the capital, Tirana, was felt across the Balkans and in the southern Italian region of Puglia across the Adriatic Sea.

Forty-five people have been found alive, while a handful of the 650 injured are in serious condition.

Prime Minister Edi Rama's government has declared a state of emergency for 30 days in Durres and Thumane.

The cash-strapped government has appealed to the public for donations of money instead of goods.

Australian Associated Press