A major earthquake struck the remote Afghan northeast on Monday, killing at least 200 people in Afghanistan and nearby northern Pakistan and sending shock waves as far as New Delhi, officials said.
The death toll could climb because communications were down in much of the rugged Hindu Kush mountain range area where the quake was centred. Reports of deaths poured in from different areas of both countries.
In one of the worst single incidents, a panicked evacuation at girls' school killed at least 12 students in the Afghan province of Takhar.
"They fell under the feet of other students," said Abdul Razaq Zinda, provincial head of the Afghan National Disaster Management Agency, who reported heavy damage in Takhar.
In the eastern Afghan city of Jalalabad, five people were killed and 55 injured, said Najibullah Kamawal, head of the provincial hospital, adding that the total could rise.
In northwestern Pakistan, at least 12 people were killed, including one in the city of Peshawar, according to government officials. Injured people were pouring into Peshawar's Lady Reading Hospital, an official said.
"We received 50 injured and more are being shifted. The injured suffered multiple injuries due to building collapse," said hospital spokesman Syed Jamil Shah.
Shockwaves were felt in northern India and in Pakistan's capital, where hundreds of people ran out of buildings as the ground rolled beneath them.
The quake was 132 miles deep and centered 158 miles northeast of Kabul in a remote area of Afghanistan in the Hindu Kush mountain range.
The US Geological Survey initially measured the quake's intensity at 7.7 then revised it down to 7.6 and later to 7.5.
International aid agencies working in the northern areas of Afghanistan reported that cell phone coverage in the affected areas remained down in the hour after the initial quake.
India's northernmost region of Kashmir experienced intense and prolonged tremors that caused panic in areas that suffered severe flooding last year. Power supplies and most mobile networks were knocked out, and there was structural damage to roads and buildings.
No casualties have yet been reported in Indian Kashmir.
The earthquake struck almost exactly six months after Nepal suffered its worst quake on record, on April 25. Including the toll from a major aftershock in May, 9,000 people lost their lives and 900,000 homes were damaged or destroyed.
The mountainous region is seismically active, with earthquakes the result of the Indian subcontinent driving into and under the Eurasian landmass. Sudden tectonic shifts can cause enormous and destructive releases of energy.
A 7.6 magnitude earthquake struck northern Pakistan just over a decade ago, on October 8, 2005, killing about 75,000 people.
Watch the VICE News dispatch from the aftermath of the earthquake in Nepal here: