The death toll from a strong 6.9 earthquake that shook a Himalayan region straddling India, Nepal and China climbed to at least 45 on Monday as authorities tried to reach remote, mountain communities to assess the full extent of the damage.

The epicenter of the quake was in the Indian state of Sikkim, about 60 kilometers northwest of the state capital, Gangtok. Officials in Sikkim said mudslides, building collapses and falling debris killed more than 20 people in the state and injured more than 50.

Indian authorities also reported quake-related deaths in Bihar and West Bengal states. The tremor was felt in the Indian capital, New Delhi, some 1,000 kilometers away and in the neighboring countries of Bangladesh and Bhutan.

China's official Xinhua news agency said at least seven people had been killed in southern Tibet, near the Sikkim border.

In Nepal, authorities reported at least seven quake-related deaths. Three died in the capital, Kathmandu, when a brick wall toppled outside the British embassy.

The quake was followed by at least two strong aftershocks of magnitudes 6.1 and 5.3. Indian authorities warned more aftershocks are possible.

A budget debate in Nepal's parliament was interrupted for 15 minutes while lawmakers fled the assembly hall as the building shook.

A reporter for VOA's Bangla service said the quake also caused cracks in some buildings in the capital of Bangladesh, Dhaka.

Indian Prime Minister Manmohan Singh called an emergency meeting of the National Disaster Management Authority to coordinate a response to the quake. The Indian air force also sent five planes to help with rescue and relief efforts.