A man is carried away after having been rescued alive from the ruins following an earthquake in Amatrice, central Italy, Aug 24, 2016. [Photo/Agencies]

The quake hit during the summer when the populations of the towns and villages in the area, normally low during the rest of the year, are swelled by vacationers.

A family of four, including two boys aged 8 months and 9 years, were buried when their house imploded. Rescue teams used heavy equipment to try to clear the wreckage, but there was no indication they had survived the disaster.

Police said two people were known to have died in the nearby village of Pescara del Tronto. Some 100 people were still unaccounted for in the village of Arquata del Tronto and two bodies were removed from the debris in Amatrice.

"Three quarters of the town is not there anymore," Amatrice mayor Sergio Pirozzi told state broadcaster RAI. "The aim now is to save as many lives as possible. There are voices under the rubble, we have to save the people there."