Dozens were injured and around 50 people remained unaccounted for after the 114,500-tonne Costa Concordia hit a sandbar near the island of Giglio off the coast of Tuscany as passengers sat down to dinner on Friday evening.
"We are not sure of the numbers, we cannot exclude that some people are missing, in fact it is very probable," said Ennio Aquilini, head of the fire service rescue operation.
IN PICTURES: The sinking of the Costa Concordia
Passengers spoke of panic and described some people leaping into the sea from the listing ship, which finally came to rest on its side, with decks partly submerged, a few hundred metres from the shore.
They said rescue efforts were continuing after a night-time operation involving helicopters, ships and lifeboats.
"We don't rule out the possibility that more people will be lost," he said.
"It's a very complex operation because some of the passengers may have jumped into the sea and not been picked up by rescuers, while others may have been sheltered in private houses and therefore not been identified yet," said Giuseppe Linardi, police chief in the nearby town of Grosseto.
PANIC
"We were sitting down to dinner and we heard this big bang. I think it hit some rocks. There was a lot of panic, the tables overturned, glasses were flying all over the place and we ran for the decks where we put on our lifevests," passenger Maria Parmegiano Alfonsi told Sky Italia television.
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