ISLAMABAD, Pakistan (AA): A powerful earthquake that rocked Afghanistan and Pakistan on Monday has left hundreds dead.

Officials from both countries put the combined death toll at 385 on Tuesday.

In northwestern Pakistan, rescue workers dug through the debris and mounds of mud as fears of aftershocks of the massive quake continued to haunt residents across the country.

Medical officials say most of the casualties were in KP province, where scores of mud houses in mountainous areas were flattened.

The latest figures issued by the government’s National Disaster Management Authority showed that the Malakund division, which comprises eight districts of northwestern Khyber Pakhtunkhawa (KP) province, were the worst-hit. Sixty percent of the 270 deaths in Pakistan occurred in this area.

Observers fear a surge in the death toll in the coming days as rescue workers make their way across several remote mountainous areas.

The government, for its part, has declared a countrywide state of emergency, while reserve medical staff have been called up to cope with the growing numbers of dead and injured.

Pakistan straddles the Eurasian tectonic plate, making it historically prone to earthquakes.

In Afghanistan, Sayed Zafar Hashimi, a presidential spokesman, said Tuesday that at least 115 people were killed and 538 were injured across the country.

Hashimi also said that 7,630 homes, 12 schools, 17 mosques and 20 office buildings were damaged in nine of Afghanistan’s 34 provinces.

Monday’s quake was the strongest to hit Afghanistan in decades, according to local observers.

The quake was also felt in several parts of India, including capital New Delhi.