At least four people were directly killed by a strong earthquake that rocked Costa Rica, and another person died of a heart attack, officials said Friday. Nearly two dozen others were reported missing.

The magnitude-6.1 quake shook the Central American nation Thursday afternoon, collapsing homes, setting off landslides that blocked major highways and trapping hundreds of people including foreign tourists in damaged mountain towns.

The Red Cross reported 14 dead earlier Friday, but agency spokeswoman Fiorella Vilca later revised the number to four who were directly killed by the quake. She blamed internal confusion as radio reports came in from remote regions.

Click here for photos.

The dead include 7- and 11-year-old sisters buried in a landslide, a 12-year-old girl and a 35-year-old man who died near the La Paz waterfall popular with tourists.

A fifth victim died of a heart attack in the capital, San Jose.

The Red Cross said more than 1,200 people were still trapped in the hardest hit zone — a mountainous area with few access roads, most of which were blocked by landslides.

"We are trying to evacuate these areas as soon as possible," spokesman Freddy Roman said.

Many residents of the area are small farmers who raise livestock or grow strawberries and ornamental plants. The region has also seen increased tourism in recent years.

Allan Flores, head of the Costa Rican Tourism Institute, told Channel 7 that about 200 Costa Rican and foreign tourists were trapped at the La Paz Waterfall Gardens hotel, a luxury eco-resort in Vara Blanca.

"There are no reports of injured tourists," Flores said. "They are all fine, and we are trying to help them. The priority is getting them out of there and bringing them to San Jose."

Local media reported that the resort suffered severe damage in the quake and visitors had to sleep outside.

When a helicopter from Channel 7 news flew over the hotel, a woman shouted in English: "We want to get out of this place! We want to get out!"

Phone calls to the resort went unanswered Friday.

There were also reports of cars being buried by landslides and widespread destruction in the remote town of Cinchona.

Resident Manuel Cambronero told Channel 7 by phone that Cinchona was destroyed.

"The only thing left is the field where we plant strawberries," he said. "It gives me chills just remembering it, because the mountains moved and all the homes collapsed on the ground."

The U.S. Geological Survey said the temblor was centered 22 miles northwest of San Jose, near the Poas Volcano National Park.

Click here for more information from the U.S. Geological Survey.