Nepal's Home Ministry while putting the death toll at 42 said another 1,117 people had been injured in the latest quake that hit hardest in remote mountain districts northeast of the country's capital Kathmandu.
The earthquake struck at 12:35 PM, some 83 km east of Kathmandu near Mount Everest at a shallow depth of 15 km, the US Geological Survey(USGS) said.
The agency had earlier measured the quake at 7.4 on the Richter Scale but later revised the intensity to 7.3.
The quake hit Dolakha and Sindhupalchowk districts - the worst-affected areas in the last month's temblor. At least 19 people were killed in Dolakha, police said.
A second tremor of 6.3-magnitude struck about 30 minutes after the 7.3-magnitude quake that sent terrifed residents running into the streets of the traumatised capital.
The USGS said there were five more aftershocks measuring over 5 on the Richter Scale after the second tremor that kept people on the edge.
Police said half-a-dozen buildings were destroyed in Kathmandu.
The fresh quake triggered massive panic among the people, who have been staying in the open since the 7.9-magnitude temblor struck on April 25, killing over 8,000 people and flattening thousands of buildings besides destroying whole villages.
"All available helicopters along with Medical Team; SSR Team going to be mobilised to Dolakha and Sindhupalchowk soon," said Nepal's National Emergency Operation Centre.
The Indian Air Force (IAF) has stationed eight helicopters in Nepal and one of them conducted an aerial survey soon after today's quake.
Nepal's only international airport, the Tribhuvan International Airport, was briefly closed by authorities and flights to Kathmandu were diverted.
Authorities have also ordered all schools to be closed for the next two weeks.
Strong tremors were felt in Kathmandu where people ran out of their houses in panic and some even started crying. Authorities appealed to people to stay in open field.
The temblor triggered landslides and toppled buildings in Nepal that recently witnessed its worst quake in over 80 years and over 160 aftershocks.
At the main hospital in Kathmandu, patients hurt in last month's quake were brought out in wheelchairs to avoid further injury.
Today's quake had its impact in several cities in Bihar, West Bengal and UP and tremors were felt across vast stretches of east and northeast India, where the death toll has reached 17 so far.
The tremors were also felt in China, where one woman was killed in Tibet.
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