An elderly man and a young girl were killed, with several other people also in "cardiopulmonary arrest", after walls collapsed in a magnitude-6.1 quake that hit Osaka in western Japan on Monday, public broadcaster NHK said. It had a depth of about 8 miles (13 kilometers) with an original magnitude measured at 5.9.
Television images showed buildings swaying and burst pipes spewing water after the quake, which struck at the height of rush hour in the city of around two million people.
Japanese broadcaster NHK reported the girl was on her way to school at the time.
Hong Kong travel agents are reporting that all their customers in Osaka are safe after a deadly quake struck Japan's second city on Monday during the height of rush hour.
"We were sleeping and it woke us up abruptly", said Kate Kilpatrick, 19, an American who was staying in a hotel in Osaka when the quake hit.
In 1995, a 6.9 quake killed more than 6,000 people in Kobe, 30 kilometers to the west of Osaka. An 84-year-old man in nearby Ibaraki died after a bookshelf fell on top of him at home, according to city officials.
Prime Minister Shinzo Abe told reporters the government was "working united, with its first priority on saving people's lives".
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Japan's Fire and Disaster Management Agency said 41 others had been injured.
Railway services in Osaka, Shiga, Kyoto and Nara, both high speed bullet trains and local rail services, were halted.
Monday's natural disaster was of a relatively low magnitude, but registered up to a lower-6 on the Japanese seismic intensity scale of 0 to 7.
Multiple small aftershocks followed the quake, and an official from Japan's meteorological agency warned residents to remain on guard. A worker there said he felt a strong jolt from below the ground at the time of the quake.
Major manufacturers such as Honda Motor Co and Mitsubishi Motors Corp resumed operations at their plants on Monday afternoon.
On Mar 11, 2011, a devastating magnitude 9.0 quake struck under the Pacific Ocean, and the resulting tsunami caused widespread damage and claimed thousands of lives. The strongest shaking was in an area north of Osaka city, the agency said.