At least six people were killed and 34 others injured when a shuttle bus carrying tourists collided with a camper and two cars on the Terni-Rieti road in central Italy, regional authorities said Monday.
The crash occurred Sunday evening near the border between the Umbria and Lazio regions.
Umbria regional President Stefania Proietti said six of the injured were in critical condition, while two others were being treated for serious injuries, according to Italian news agency ANSA.
She described the crash as a "catastrophic" mass-casualty emergency, saying the regional emergency protocol was activated immediately after the first emergency call.
The shuttle bus was transporting tourists to Marmore Falls, one of Italy's best-known natural attractions, Proietti said.
The injured were taken to hospitals in Terni, Perugia, Spoleto, Foligno and Rieti, while passengers who were unhurt but stranded after the crash were provided accommodation in Terni.
Proietti thanked emergency responders and the Lazio regional health system for assisting in the rescue operation but declined to comment on the cause of the crash, saying police were investigating the incident.