Rescue teams battled landslides and torrential monsoon rains Monday after a powerful earthquake rocked a vast and remote Himalayan region, killing at least 53 people in India, Nepal and Tibet.

The epicentre of Sunday's 6.9-magnitude earthquake was in an isolated area of the border between India's Sikkim state and Nepal, and there were fears the toll could rise as reports filtered in from distant towns and villages.

The heavy rains and low cloud grounded helicopter flights in the area, and Indian relief and rescue teams trying to access the Sikkim state capital, Gangtok, were blocked by landslides on the only viable highway.

"Our rescue teams are stuck in that corridor," said National Disaster Response Force spokesman Surendra Ahlawat. "The conditions are terrible, but road crews are doing their best."

More than 5,000 army troops were deployed in the area to try and restore road links with Gangtok and further north towards the epicentre.

"The biggest challenge now is to get the rescue teams to the affected areas," said Sikkim Information Minister C.B. Karki.

The death toll in the state stood at 31, with five people killed in Gangtok and the others dying in building collapses and landslides in outlying areas, including two soldiers on road clearing duty.

"There's a good chance the toll could rise as rescue teams begin to access the more remote areas," said G. Anandan, chief of the central emergency control room in Gangtok.

Tremors were felt more than 1,000 kilometres (600 miles) away in New Delhi to the west, and in Bangladesh to the east.

In Nepal, police said a motorcyclist and his eight-year-old daughter were among three killed when a wall crumbled at the British embassy compound in the capital Kathmandu, 270 kilometres west of the epicentre.

Three others were killed in separate incidents in eastern Nepal.

A budget debate in Nepal's parliament stopped for 15 minutes when lawmakers leapt to their feet and fled the chamber as the entire building shook.

More than 100 people were injured by mudslides, falling debris and collapsing buildings in Gangtok, where thousands spent the night in the streets after two large aftershocks sparked further panic.

"People are still very worried and tense. Everything is shut down and nearly everyone is still out in the street because they're scared of another quake," said Gangtok resident Indira Singh.

The shockwaves downed power lines, blacking out most of Sikkim and further hampering rescue efforts as telephone land lines were interrupted and panicked mobile users swamped local networks.

The quake was felt across a wide region including the Himalayan kingdom of Bhutan after it struck at about 6:10pm (1240 GMT) on Sunday, according to the US Geological Survey.

Its epicentre was just over 60 kilometres northwest of Gangtok, at a relatively shallow depth of 19.7 kilometres.

The Press Trust of India said that police rescued 15 foreign tourists in the north of Sikkim, a popular destination for trekkers.

Nine other people died in India, including one killed in a stampede by panicked residents in Bihar state and four who were buried when a house fell down near Darjeeling.

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

Nepalese police spokesman Binod Singh said 68 people had been injured in the Kathmandu Valley, while hundreds of homes were damaged in eastern Nepal.

Strong tremors were felt in Guwahati, the main city in India's Assam state, some 600 kilometres away, sending people running into the streets.

"Our apartment block was literally swaying," said housewife Anamika Das.

India's seven northeastern states, joined to the rest of the country by a narrow sliver of land known as the "chicken's neck," are located in an area of frequent seismic activity.

The most recent deadly earthquake in India, with a magnitude of 6.7, struck the western state of Gujarat in 2001, killing more than 20,000 people.

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