Three of the victims have died in the hospital. The 10 injured, including three children, are in critical condition at area hospitals.
The bus followed 50 people who returned to Naples after a pilgrimage, according to Italian media.
A failure in the brakes was identified as a possible cause of the accident to the bus, which collided with several vehicles, after having left the road and fell off a bridge, about 30 meters high, with some of the passengers were spat.
The origin of the accident has not been determined.
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