Two dead, children trapped after quake hits Italian holiday island Ischia

A magnitude-4.0 earthquake struck the Italian holiday island of Ischia, causing destruction that left two people dead at peak tourist season, authorities said, as rescue workers struggled early Tuesday to free two children from the rubble.

Italian media say up to 10 others are unaccounted for after buildings in the town of Casamicciola, in the north of the small tourist island, collapsed.

A woman was killed when she was hit by debris that fell from a church, with the body of another spotted in the rubble of a collapsed house, local media reported.

Around 4am emergency workers rescued a seven-month-old baby, crying but alive, after hours of effort. They were still struggling to free the baby's two brothers, who were alive but trapped and communicating with emergency services through the rubble, according to Naples prefecture.

According to local media, the two children, aged 4 and 7, are trapped under a bed but are in touch with rescue workers by phone. It was their pregnant mother, healthy and safe, who raised the alarm. The father was rescued at 2:30am.

"In Casamicciola, a building collapsed and three people were pulled alive from the rubble - two women and a man," the head of the local department of civil protection, Angelo Borrelli, said at a press conference early Tuesday.

Two small communes, Casamicciola and neighbouring Lacco Ameno, had borne the brunt of the quake, he added.

The tremor hit the northwest of the island at 8:57pm, with a depth of some 10 kilometres. The main earthquake was followed by 14 smaller aftershocks, Borrelli said.

Residents and tourists on the island, which is crowded at the height of the summer season, ran out on to the streets from homes and hospitals.

The island off the coast of Naples has a population of about 50,000 and is extremely popular with tourists.

Television images showed that about six buildings in the town as well as a church had collapsed in the quake. At least one hotel and parts of a hospital were evacuated. Roberto Allocca, a doctor from a local hospital, told Sky TG24 television that at least 20 people were being treated for minor injuries at a makeshift emergency room set up on the hospital grounds. Allocca said the situation was calm and under control.