Video report by ITV News Correspondent Ben Chapman
Italy's prime minister has declared a year-long state of emergency as desperate efforts continue to try to save people trapped under the rubble of Genoa's collapsed motorway bridge.
The rescue effort comes as a family of three, including a seven-year-old boy, were confirmed to be among the at least 39 people who died when the Morandi Bridge fell.
Roberto Robbiano and Ersilia Piccinino's son was one of three children killed in the collapse of the major four-lane motorway bridge during a violent storm on Tuesday morning.
A further 16 people were hurt in the collapse, 12 of who are said to be seriously injured.
It is thought some 20 vehicles plunged up to 150ft into a void after a 200-metre section of the Morandi Bridge collapsed on Tuesday over an industrial zone.
There are fears up to 12 people may still be trapped.
ITV News Reporter Ben Chapman explains why time is running out to save people trapped.
The disaster occurred on a highway which connects Italy to France on the eve of a major Italian holiday called Ferragosto, meaning traffic would have been heavier than usual as many Italians travelled to beaches or mountains.
ITV News Anchor Tom Bradby looks back at the bridge's history
So far, at least 11 people have been pulled alive from the rubble of the bridge, while rescuers and sniffer dogs continue the search through tonnes of concrete slabs and steel for survivors or bodies.
The rescue operation has been likened to one following an earthquake, such is the scale and weight of the destruction.
Two Albanian men were killed in the collapse, named by authorities as Marjus Djerri and Edi Bokrina.
Three French nationals were also said to have died, with local media reporting that the two young women and a man from Toulouse had travelled to Italy for a music festival.
Italian Prime Minister Giuseppe Conte declared the 12-month state of emergency a day after visiting the site of the disaster.
He described the collapse as an "immense tragedy", saying: "It is shocking to see the twisted metal and the bridge collapsed with victims who were extracted."
A former Italian professional footballer described his remarkable escape from death after his car went down with the motorway bridge in Genoa.
Davide Capello, 33, a former goalkeeper for Italian club Cagliari, managed to miraculously walk away from the disaster despite plunging 100ft.
He told Sky TG24: "I was driving along the bridge, and at a certain point I saw the road in front of me collapse, and I went down with the car."
“I was able to get out. I don't know how my car wasn't crushed. It seemed like a scene from a film, it was the apocalypse."
Footage shows a bystander screaming as he witnesses the 200-metre section of the bridge collapse
A man who was under the highway bridge that collapsed called it "a miracle" that he survived.
He told local Italian television that he was standing in front of his truck under the bridge in the city of Genoa when the structure collapsed Tuesday.
He says the shockwave sent him flying over 10 meters into a wall, injuring his right shoulder and hip.
"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 rescue operation is ongoing for victims crushed in the rubble
It is currently not known what caused the 260ft long stretch of highway to break off from the 150ft high bridge in the north-western port city, and fears are rising that a part of the Morandi Bridge which is still standing could also coming crashing down.
Authorities have widened their evacuation to include some 630 people living near the highway bridge that was carved in two by the collapse of its mid-section during a violent storm.
Genoa prosecutor Francesco Cozzi said that the investigation into the collapse is focusing on human causes, specifically the possibility of inadequate maintenance or a design flaw in the bridge’s construction.
He said: “I don’t know if there is responsibility. For sure it was not an accident.”
Meanwhile, engineering experts have noted that the bridge was 51-years-old, meaning corrosion and weather could also have been factors in its collapse.
Others have said that although the bridge was considered innovative in its time for its use of concrete around its cables, the design of the 1967 structure meant that no repairs could be done to the metal cables if needed.
The bridge had also long been due for an upgrade, especially since the structure saw more heavy traffic than its designers had envisioned.
One expert in construction from the University of Genoa, Antonio Brencich, had previously called the bridge “a failure of engineering”.
Mehdi Kashani, an associate professor in structural mechanics at the University of Southampton in the UK, said pressure from dynamic loads, such as heavy traffic or wind, could have resulted in “fatigue damage” in the bridge’s parts.
The scale of the damage was captured on video by rescue teams flying over the collapse
The Italian CNR civil engineering society has said that structures dating from when the Morandi Bridge was built had surpassed their lifespan, and called for thousands of Italian bridges and viaducts built in the 1950s and 1960s to be replaced.
Work to upgrade the bridge with a £17.8 million project had already been approved, with public bids for the work to be submitted by September.
According to local media, the improvement work involved two weight-bearing columns that support the bridge – including one that collapsed on Tuesday.
Meanwhile, Italian politicians were busy pointing fingers at possible culprits.
Italy’s deputy premier, Luigi Di Maio, blamed the bridge collapse on a lack of maintenance by Autostrade Per Italia, the private company that operates many of the nation’s toll highways.
However, Italy’s minister of transportation and infrastructure, Danilo Toninelli, said the company responsible for highway has said no maintenance work was under way at the time of the collapse and that maintenance work was up to date.
Mr Di Maio, who leads the anti-business 5-Star Movement party that is part of Italy’s coalition government, also blamed previous Italian governments of turning a blind eye to the health of the nation’s toll highways because of political contributions.
Mr Toninelli, also from the 5-star party, threatened in a Facebook post that the state, if necessary, would take direct control of the highways agency if it could not properly care for roads and bridges.
In 2013, some 5-Star MPs had questioned the wisdom of an ambitious and expensive infrastructure overhaul programme as possibly wasteful, according to reports, but a post about that on the Movement’s site was removed on Tuesday after the bridge’s collapse.
Within hours of the collapse, Mr Salvini was vowing not to let European Union spending strictures on Italy, which is laden with public debt, stop any effort to make the country’s infrastructure safe.
Genoa is a flood-prone city, and officials have warned that the debris from the collapse must be removed as soon as possible.
Some of the wreckage landed in a dry riverbed that could flood when the rainy season resumes in a few weeks.