Coast guard officials said the ferry was carrying 189 passengers and crew when it overturned on Thursday, minutes after it left a central Philippine port in choppy waters.

They said at least 127 people from the M/B Kim Nirvana were either rescued by nearby fishing boats and coast guard personnel, or swam to safety off Ormoc city on Leyte Island.

Coast guard spokesman Armand Balilo said the wooden outrigger ferry was leaving Ormoc for the Camotes Islands, about 44 kilometres to the south, when it was lashed by strong waves.

He said the captain and some of the crew were rescued and are in custody pending an investigation.

Coast guard officials and survivors said it wasn’t immediately clear what caused the 36-tonne ferry, which was carrying a heavy cargo of construction materials and bags of rice, to overturn.

Survivors said the bow suddenly rose from the water before the vessel flipped over on one side, turning it upside down and trapping passengers underneath.

Among the passengers who survived were at least three Americans and a Canadian.

Lawrence Drake, 48, a retired firefighter from Rochester, New York, said he was able to revive a woman who wasn’t breathing while they were in the water via mouth-to-mouth resuscitation.

Mr Drake said he also saved the woman’s pregnant daughter and an eight-year-old boy. He said he saw at least seven bodies floating in the water, including two children.

Many of the passengers were screaming in panic, he said.

Mr Drake’s Filipino wife, Mary Jane, said the ferry was pulling slowly out of the port when it suddenly flipped to the left in strong waves.

“No one was able to jump out because it overturned very swiftly. There was no time to jump,” she said.

TV footage showed coast guard rescuers and army soldiers carrying survivors from rubber boats to a beach.

Not far away, the bottom part of the vessel could be seen protruding from the water.

A rescue leader, Ciriaco Tolibao, said army frogmen and coast guard divers were searching the overturned boat to find more survivors or retrieve bodies.

Cloudy weather at the time of the accident did not pose any danger that would have prompted the coast guard to stop sea voyages, the coast guard said.

A brewing storm in the Pacific was 550 kilometres east of Ormoc and was too far away to affect any part of the Philippine archipelago, according to forecasters. They said winds in the Ormoc region were not strong enough to whip up dangerous waves.

Ormoc, a regional economic and transportation hub of about 200,000 people, is located in a disaster-prone eastern region that is regularly hit by some of the approximately 20 tropical storms and typhoons that blow in from the Pacific each year.

The city was among those devastated by Typhoon Haiyan, one of the most ferocious storms on record to hit land, which left more than 7300 dead and missing and levelled entire villages in November 2013.

In 1991, a storm set off flash floods in the Ormoc region that killed more than 5000 people and swept homes and vehicles into the sea.