Four more survivors have been pulled from the rubble of a hotel crushed by an avalanche in Italy.

Emergency crews have rescued 11 survivors from Hotel Rigopiano, in the eastern Abruzzo region, which was buried when the avalanche struck Wednesday afternoon.

All four children who were in the hotel at the time have been pulled out alive and pictures have emerged of their dramatic rescue.

Four dead bodies have also been recovered and the search is ongoing for around 15 people who are still unaccounted for.

Following the latest rescues the mayor of the tiny town of Farindola, Ilario Lacchetta, said: "Today is a day of hope. There's a miracle under way."

Emergency crews have had to use skis to reach the scene as the road was blocked by heavy snow.

Hospital officials told the Associated Press news agency they had symptoms of hypothermia and dehydration, but were otherwise in good health.

Relatives of people still missing have gathered at a hospital where they await news.