Six people have died, and 26 are injured after a huge crash in Italy. The tourist shuttle bus was travelling along the SS79 Ternana road in the province of Rieti, in the Lazio region near the border with Umbria, when it collided head-on with a camper van before two cars also became involved in the crash on Sunday evening.

According to Umbria regional authorities, six people lost their lives in the collision. Regional president Stefania Proietti said six of the injured were in a critical condition, while two others were being treated for serious injuries, according to Italian news agency ANSA. In an update on Monday afternoon, regional authorities said 15 people remained in hospital, while 19 had been discharged. Among those still receiving treatment was a four-year-old girl, who Italian newspaper La Nazione reported was not in a life-threatening condition.

The privately operated bus had been transporting tourists to Marmore Falls, an ancient Roman waterfall near the city of Terni.

Ms Proietti described the collision as a "catastrophic" mass-casualty incident and said the regional emergency protocol was activated immediately after the first emergency call.

Those injured were taken to hospitals in Terni, Perugia, Spoleto, Foligno and Rieti for treatment.

Italian media reported that all six people who died were Italian nationals.

Among the victims were Paolo Cosci and Graziella Baldini, a couple from the Tuscan town of Massa who had been travelling on the bus.

Paying tribute, Massa mayor Francesco Persiani wrote on Facebook: "In the very serious road accident that occurred along the Terni–Rieti highway, two of our fellow citizens, Paolo Cosci and Graziella Baldini, also lost their lives.

"It is a deep sorrow that affects our entire community."

According to La Nazione, three of the other victims were bus driver Federico Romualdi and Giampiero Colasanti and Daniela Bellanca, a couple who had been travelling in the camper van.

The identity of the sixth person who died has not yet been released