FOUR more people have been rescued from the hotel in Italy destroyed by an avalanche three days ago.

So far, nine people have been recovered alive from the Rigopiano hotel in the eastern Abruzzo region.

At least 15 people are still missing after the avalanche occurred following several earthquakes and heavy snowfall.

While one more survivor has yet to be rescued, Italian media said other voices may have been heard in the ruins.

Five people have been confirmed dead.

The first five survivors were taken to safety on Friday around 40 hours after the avalanche hit on Wednesday.

They had reportedly taken refuge beneath a collapsed portion of ceiling, where they were able to light a fire to keep warm for two days.

The rescue has been hampered by deep snow blocking an access road.

There are also concerns that further avalanches could follow, Italian newspaper La Stampa reported.

The first person pulled out on Friday was an eight-year-old boy, the son of a holidaymaker, Giampiero Parete, who had gone to his car when the avalanche struck and first sounded the alarm by calling his boss.

The boy's mother, Adriana, and her six-year-old daughter were also later saved.