Afghanistan suffered its strongest earthquake in more than six decades on Monday, but the full scope of the damage is not yet clear because the worst affected areas are not easily accessible, according to Boston-based catastrophe modeling company AIR Worldwide.

A 7.5 magnitude quake struck 158 miles north of the Afghan capital at a depth of 132 miles, the U.S. Geological Survey said. It was the first major temblor in the region since April, when a 7.8 earthquake in Nepal killed more than 8,000 people and triggered deadly avalanches on Mount Everest.

The quake caused landslides, disrupted mobile phone networks and caused houses to collapse in Pakistan, according to news reports. At least 228 people were killed in Pakistan, and more than 1,000 injured, the Associated Press reported. In Afghanistan, officials said 33 died with more than 200 casualties, according to AP.

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