Seven people have been pulled out alive from the wreckage of a collapsed bridge in the northern Italian city of Genoa as it is confirmed 26 have died.
This figure could rise, as 16 people are injured.
Earlier reports suggested as many as 35 had died, with the Interior Ministry also saying "about 30" had been killed.
The dead include at least one child, reports the Corriere newspaper, quoting the Interior Ministry.
Two of those rescued were flown to hospital by helicopter, firefighters said, while rescuers say a further 10 people are missing.
Thirty-five cars and three heavy vehicles are under the bridge, Italian Civil Protection said.
In the early evening, the fire service said the number of firefighters on the scene had risen to 300.
Firefighters still heard voices from under the rubble up almost 12 hours after the collapse, fire official Bruno Frattasi told state broadcaster RAI.
Seven survivors have been pulled out so far.
"We are still trying to extract survivors from the rubble," Genoa police official Alessandra Bucci said. "We hope to find more people alive."
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A family believed to be going on holiday have been found in the rubble, with rescuers saying they found suitcases inside the car. A former professional footballer experienced a "miracle" as he survived after he fell while driving on the bridge as it crumbled.
The vehicles plunged a significant distance into a river and an industrial area when a large section of the Morandi Bridge collapsed at about 11.30am during a sudden and violent storm.
As Prime Minister Giuseppe Conte arrived in Genoa, with plans to stay in the city over night, he confirmed the number of dead was verified to be 22.
Italian Deputy Transport Minister Edoardo Rixi told SkyNews24 the number of dead is set to rise.
"It's not acceptable that such an important bridge... was not built to avoid this kind of collapse...The central section came down," he said.
A fire service spokesperson told AFP that the bridge had mostly fallen on rail tracks below, taking "cars and trucks" with it
As emergency services personnel picked through ground strewn with huge chunks of rubble and metal, they searched large white lorries, which were left overturned and smashed into pieces, lying upturned with their wheels in the air.
A man who was under the bridge says it's "a miracle" that he survived.
The unnamed middle-aged man told Italian media he was stood in front of his truck under the bridge as the structure collapsed Tuesday.
The man, speaking in Italian to reporters as walked away from the disaster site, said the shockwave sent him flying over 10 metres (33 feet) into a wall, injuring his right shoulder and hip.
He says "I was in front of the truck, and flew away like everything else. Yes, I think it's a miracle. I don't know what to say. I'm out of words."
A white car had been flattened as if it had been in a crusher, one of its doors squeezed outwards and its windscreen improbably still intact.
Video showing parts of the structure falling has been posted to Twitter by local police and what appears to be flashes of electricity are visible as concrete columns shatter and drop into water.
Around 200 firefighters have been responding to the incident and have told the Associated Press they are concerned about gas lines.
A witness told Sky Italia television he saw "eight or nine" vehicles on the bridge when it collapsed in what he called an "apocalyptic scene".
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Transport Minister Danilo Toninelli said in a tweet that he was "following with great apprehension what seems like an immense tragedy".
Video captured the sound of a man screaming: "Oh God, oh, God."
Other pictures included one of a green truck that had stopped on the bridge just yards short of the gaping hole in the road surface.
The mayor of Genoa Marco Bucci said: "The collapse of the Morandi bridge is an immense tragedy for our city...But we must react immediately with strength and pride ".
The bridge is part of the A10 toll road which runs into the port city and is likely to have been busier than usual as it is the eve of Farragusto, a major Italian summer holiday marking the religious feast of the Assumption of Mary.
Traffic would have been heavier than usual as most cities and businesses are closed as Italians head to the beaches or the mountains.
Restructuring work on the bridge, which was constructed in the 1960s, was carried out in 2016.
The collapse is believed to have been caused by a structural weakness, the ANSA news agency said.