An earthquake hit the tourist-packed Italian holiday island of Ischia on Monday night, collapsing buildings, killing at least two people and injuring dozens, officials said.
Residents and tourists on the island off the coast of Naples ran out on to the narrow streets from homes and hotels. Fearing aftershocks, many decided to leave the island early.
Television images showed about six buildings in the town of Casamicciola including a church had collapsed in the quake, which hit at 8.57pm local time.
The quake hit a few days before the first anniversary of a major quake that killed nearly 300 people in central Italy, most of them in the town of Amatrice.
Italy's National Institute of Geophysics and Vulcanology put the magnitude of Monday's quake at 4.0, revising it up from an initial 3.6, but both the US Geological Survey and the European quake agency estimated the magnitude at 4.3.
The director of the island's hospital said two people were killed and about 40 injured. One of victims was killed when she was hit by falling masonry from the church of Santa Maria del Suffragio, the Civil Protection Department in Rome said.
Most of the damage was in the high part of the volcanic island. Hotels and residences on the coast did not appear to suffer serious damage.
Helicopters and a ferry boat brought in more rescue workers from the mainland.
Three extra ferries were provided during the night for about 1,000 residents and tourists who wanted to leave. As daylight broke, dozens of people went to the island's four ports, having decided to end their vacations early.
A few people were pulled out alive from the rubble, including a seven-month-old baby. A few others, including two children, were located still alive and rescuers were working to free them, according to media.
Roberto Allocca, a doctor from a local hospital, told Sky TG24 television that about 25 people had been treated for minor injuries. Most of the hospital had been evacuated and the injured were treated outside.
Some civil protection squads were already on the island because of brushfires.
Ischia, a volcanic island about a one-hour ferry ride from Naples, is popular with German tourists. German chancellor Angela Merkel has stayed there often.