Rescue workers braved sub-zero temperatures as they worked into the night to free people trapped under hundreds of collapsed buildings in the worst hit towns, Bolu and Duzce, which are roughly halfway between Istanbul and Ankara. In some cases, rescuers say they are digging without knowing if anyone was in the building when it fell. Almost 1,800 people were being treated for injuries.
Turkey's second violent earthquake in three months - more than 17,000 people died in the same region in August - has cast a pall over Mr Clinton's visit and this week's summit of the Organisation for Security and Co-operation in Europe in Istanbul, but the government is pressing ahead with plans for both.
Fear of further shocks was heightened by a warning from Professor Ahmet Mete Isikara, Turkey's leading seismologist, that the latest earthquake had activated a major fault system which could have a "devastating" effect on Istanbul. Professor Isikara said a major earthquake could hit the metropolis of 12 million, but it was impossible to predict when.
Rescue teams rushed to the scene of the latest quake from around the world - notably from Greece, whose help to Turkey in August helped to forge friendship between the two bitter enemies. The authorities, however, have learned from their mistakes three months ago, when official aid organisations lagged behind the volunteers, and the military visibly did nothing while the people dug in despair. This time, both civil and military launched a well-organised relief effort.
Repairing the damage will put further strain on Turkey's shattered economy. Yesterday the country's transport minister estimated that Friday's disaster will add $10bn (pounds 6bn) to the $13bn cost suffered in August.
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