The fire service confirmed they had rescued the 11-year-old at 14:12 local time (12:12 GMT), some 16 hours after the quake struck.

His baby brother was the first to be pulled out, in the early hours; then his eight-year-old sibling mid morning.

At least two women died and 39 people were injured in the quake.

The 4.0 magnitude quake struck in the mid-evening, at a depth of around 5km (3 miles), just north of the Casamicciola commune.

Ischia, off the coast of Naples, has a population of about 50,000 and is hugely popular with tourists, many of whom were out in bars and restaurants when the shaking started.

"A horrible experience, everything was shaking, plunged into darkness, houses were collapsing... a nightmare," one person wrote on Twitter.

Another said: "I was on the couch watching TV. Blackout, shaking, something fell on my head. I scream, my mother grabs me and we ran outside."

There were huge cheers when 11-year-old Ciro was pulled free from the rubble of his family home. He was credited with saving his brothers by pushing them under the bed when the shaking first started.

His seven-month-old brother Pasquale was the first to be brought out, at 04:00. Rescuers were able to pass water through a tube to Ciro, and his eight-year-old brother Mattias, as they worked to get them out.

"I promised them that after this was all over we would all go get a pizza together," one rescuer told Italian television.

The boys' parents and another woman had managed to escape from the building earlier, and raised the alarm about their children.

Hotels, homes and a hospital were among a number of buildings damaged. One elderly woman was reportedly killed by debris falling from a church, while another body was found in the rubble of another collapsed building.

Civil Protection Department head Angelo Borrelli said some 2,600 people were unable to re-enter their homes while safety checks were being carried out around the island.

Extra ferries, from Naples to Ischia, were laid on during the night to bring more rescue workers to the island and allow holidaymakers to leave. Dozens of people are said to have ended their holidays early and Italian media said some tourists were sleeping on benches waiting for boats to arrive.

An emergency response team was quickly on the scene, partly because additional numbers were already on the island to fight localised bush fires.

Ischia, about an hour's ferry ride from Naples, is no stranger to earthquakes. Its worst came in July 1883 when a 5.8-magnitude quake killed more than 2,000 people.