Four people were killed and some 120 were injured in the Turkish city of Izmir after a powerful earthquake rocked its Aegean coast. Images coming from the city show significant damage, suggesting the death toll may rise.

Of the four people confirmed dead, one drowned during the quake, Turkey’s Disaster and Emergency Management Presidency said in a statement on Friday, citing preliminary data from local authorities. A further 120 people received various injuries, it said.

Shortly after the quake, Izmir’s Ege University urged the public to donate blood at its blood center as a “precaution,” signaling that the number of injured may potentially overwhelm the city’s emergency units.

The Turkish authority has measured the earthquake at 6.6 in magnitude, while both the European-Mediterranean Seismological Centre (EMSC) and the United States Geological Survey (USGS) said it was 7.0.

At least 33 aftershocks followed the destructive earthquake, with 13 of the jolts exceeding a magnitude of 4.0, the Turkish data said. The epicenter of the primary quake was located at a depth of around 16km off the Aegean coast, affecting both the Turkish mainland and Greek islands in the Aegean Sea. The tremor was even reportedly felt in Athens.

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Turkey’s Izmir and its namesake province have apparently experienced the worst impact. Izmir is Turkey’s 3rd largest city, with a population of some 3.7 million. Up to 20 buildings were destroyed by the quake across the province, Izmir’s Governor Yavuz Selim Kosger said in a statement.

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Imagery from the scene shows that several multi-story buildings in Izmir have been completely flattened by the powerful tremor.

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