The tremor was the second in just over a week.
Dozens of aftershocks have shuddered through Italy’s northern Emilia Romagna region overnight.
The latest victim has been pulled from the rubble in the town of Medolla, some 27 miles (45km) north-west of Bologna, Italian media report.
Officials say the strongest overnight tremor had a magnitude of 3.54.
The first quake on May 20 killed seven people and left thousands homeless with the 6.0 magnitude tremor causing significant damage to the region’s cultural heritage, destroying churches and historic buildings.
After the second quake, the number of people made homeless has now gone up from 6,000 to 14,000, the Italian government says.
A woman who was saved in the small town of Cavezzo reportedly spent 12 hours in the rubble in her kitchen. The 65-year-old managed to survive because a piece of furniture had toppled over, preventing her from being crushed by the wreckage.
She was taken to hospital.
Prime Minister Mario Monti has pledged that his government will do everything possible to restore normal life to the area, which he said was “so special, so important, so productive for Italy”.
Government troops are now deployed in the affected areas, and an emergency cabinet meeting will be held later on Wednesday.
The latest quake struck 40 km (25 miles) north of Bologna at a depth of 9.6 km (6 miles) at about 09:03 local.
Thousands of residents ran out of buildings after the tremor, which was felt as far away as Venice and the Austrian border.
The towns of Mirandola, Medolla and Cavezzo were closest to the epicentre, but the northern cities of Milan and Bologna were shaken too.
Among the dead were four people in Mirandola, including two who were in a factory that collapsed. Three people also died in San Felice, and two in Cavezzo.
In Mirandola, the San Francesco church collapsed, leaving only its facade standing.
Three people were killed at a factory that had only just been cleared for re-entry, following the earlier quake, reports said.
A parish priest in the town of Rovereto di Novi was said to have been killed by a falling beam when he went back into his church to save a Madonna statue.
“It’s a disaster, I’ve never seen anything like it,” Cavezzo Mayor Stefano Draghetti was quoted as saying by Reuters.
Emilia Romagna – one of Italy’s most agriculturally productive areas famous for many delicacies – has been struggling to recover from the previous quake.
Reports say that Tuesday’s tremor dealt a blow to the region’s world-famous balsamic vinegar industry – after the previous quake nine days ago hit Parmesan production.
In 2009, an earthquake in L’Aquila, central Italy, killed nearly 300 people.
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