Italy's most powerful earthquake in 36 years dealt a new blow on Sunday to the country's seismically vulnerable heart, sending terrified residents fleeing for the third time in nine weeks and flattening a revered six-century-old church.

Fabrizio Curcio, head of the national civil protection agency, said around a dozen people had been injured but that there did not appear to have been any fatalities.

"We are checking, there are several people injured but for the moment we have had no reports of victims," Curcio said.