Another powerful earthquake rattled Italy’s northern region of Emilia Romagna on Tuesday, killing at least 17 people.

The five-point-eight magnitude earthquake injured more than 200 people, and search efforts are under way for four missing people.

Due to the quake, railway operations halted temporarily in Milan and Florence. Tremors were also felt in Bologna, Pisa and Venice, prompting people to evacuate to nearby apartments and offices.

The Emilia Romagna region was hit by a six magnitude quake just nine days ago. That quake killed seven people, injured roughly 50 others, and displaced around seven-thousand more.