CAVEZZO, Italy - An earthquake killed 16 people and injured about 350 in northern Italy on Tuesday, spreading fear among thousands of residents living in tents after a similarly strong tremor in the same region flattened their homes nine days ago.

Rescue workers search through the debris of a factory which was damaged after an earthquake, in Medolla near Modena May 29, 2012.[Photo/Agencies]

Rescuers were searching through the rubble of houses and warehouses in the Emilia-Romagna region, where several building sites had just reopened after the previous quake on May 20.  

Officials said 16 people were confirmed dead, more than twice the number killed in the May 20 quake that, like Tuesday's, had its epicentre near the city of Modena. The number of those forced to leave their homes doubled to 14,000.

Many residents ran out of buildings when they felt the 5.8-magnitude tremor, which hit shortly after 0700 GMT just as operations to rebuild the quake-struck region were under way.

"As we were coming down the stairs, we heard the sound of crumbling houses around us. There was a big cloud of dust," said 72-year-old Giulio in Cavezzo, a badly damaged village about 30 km (20 miles) from Modena where three died.

Rescuers searched tirelessly for survivors despite initial operations being hampered by disruption to the mobile phone network and to the railway network around Bologna.

A woman was pulled alive from the debris of her house in Cavezzo after 12 hours searching, according to Sky Italia.

The quake was the most deadly to strike Italy since 2009 when a tremor partially destroyed the central city of L'Aquila, killing about 300 people and leaving thousands homeless.

With its streets deserted, Cavezzo looked like a ghost town. A shop in the centre still had fruit displayed on stalls outside in the street.  

In a nearby empty coffee shop a half-eaten croissant was left on a plate on the bar and an apron lay on the floor.

"It's a disaster, I've never seen anything like it. An endless series of very strong tremors after those of May 20, which had already pulled everything to its knees," said a very shaken Stefano Draghetti, mayor of Cavezzo.

"We need a lot of help to restart, from those who can - the state, the European community."

Italian media showed buildings and shopping malls shaking and collapsing under the force of the quake and ambulances racing across towns. Churches and factories were badly damaged.

In Medolla, also near the epicentre, an electromedical equipment plant collapsed, killing a worker. Rescuers were frantically searching for three other workers still believed to be under the rubble, a Reuters witness said.

"The situation is one of great fear and uncertainty," said Salvatore Iannizzotto, provincial head for the Modena police.

"The population was becoming more relaxed and slowly moving back into their homes. They have now left their homes again."

The civil protection service was setting up new emergency campsites to provide residents with shelter for the night.