Albanian families buried their loved ones on Friday and the country mourned the 49 people known to have died in this week's earthquake, as officials grapple with the destruction left in its wake.

Entire families were crushed by their homes when the 6.4 magnitude earthquake -- the most deadly and devastating in decades -- jolted the Balkan country before dawn on Tuesday.

In the town of Thumane, where numerous buildings collapsed, loved ones wept before the six wooden coffins of the Cara family and three more belonging to the Greku family.

The 6.4 magnitude quake that jolted Albania before dawn on Tuesday was the most deadly and destructive in decades
The 6.4 magnitude quake that jolted Albania before dawn on Tuesday was the most deadly and destructive in decades AFP / Armend NIMANI

The victims were among more than 20 people whose bodies were pulled from ruins in Thumane, where a sombre silence reigned on Friday after the frenzy of the search effort had ceased a day earlier.

"Respect the dead," said Fatmir, a relative of the Cara family, shooing away media.

Prime Minister Edi Rama attended the funerals, kneeling down to toss dirt on the coffins in a local custom of respect.

In a message of condolences posted on Facebook, he wrote in Albanian "You will never be alone".

The damage was most concentrated near the Adriatic coast in the port city of Durres and the town of Thumane
The damage was most concentrated near the Adriatic coast in the port city of Durres and the town of Thumane AFP / Armend NIMANI

In the other hard-hit coastal city of Durres, search efforts focused on a toppled hotel on the Adriatic shore.

Around 45 people have been rescued this week by relief teams who worked around the clock with foreign experts -- who brought dogs, cameras and other equipment to comb the rubble.

Of some 750 people who were treated for injuries, three victims were flown to Italy on Friday for specialised care.

Map locating earthquake damage in the Albanian cities of Durres and Thumane.
Map locating earthquake damage in the Albanian cities of Durres and Thumane. AFP / Patricio ARANA

Among them was the sole survivor of the Lala family in Durres, 17-year-old Rame Lala. He lost eight relatives when their four-storey home was flattened by the tremor.

"We have all been touched and wounded," Edi Rama said in the morning as Albania, one of the poorest countries in Europe, took stock of the losses.

His voice strained as he mentioned the death of a close friend of his son, a medical student whose body was found in the rubble with her brother and two parents.

Rama, who has promised to build new homes for the victims by 2020, said almost $7 million had already been received in donations.

In Durres and Thumane, almost 2,000 people have been moved into hotels or other buildings -- either because of severe damage to their homes or because hundreds of aftershocks made their apartments unsafe.

Another 3,480 people in the capital Tirana fled to shelters, with some now housed in reception centres and many staying in the homes of relatives, Rama said.

There were no casualties in Tirana but nearly 70 buildings and 250 homes were damaged.

Defence Minister Olta Xhacka urged residents to leave any homes affected by the quake, saying experts were preparing to asses the risks.

"The situation of buildings with damaged structures is as dangerous as on the first day, so don't stay there, leave them," she said.

Albania's towns developed chaotically after the fall of communism in the 1990s.

A lot of construction was done "without a building permit, without respecting rules... using non-standard materials", local architect Maks Velo told AFP.

Earthquake