Image provided by Ipora's Road Police shows the scene of a major road accident on a highway in the state of Parana, Brazil, on Oct. 31, 2016. At least 20 people were killed and several injured during a collision of a bus and a truck in Brazil's south state of Parana on early Monday morning, according to an official source. (Xinhua/Ipora's Road Police)

SAO PAULO, Oct. 31 (Xinhua) -- At least 20 people were killed and several others injured on Monday in a road accident in Parana, Brazil, local media reported.

A bus collided head-on with a truck on the PR-323 highway in Cafezal do Sol, killing 19 people on the spot.

Another passenger, a girl who was injured in the crash, died on the way to the hospital, the Fire Department said.

The bus carried 30 passengers, some of them patients at a local hospital, when the crash happened, according to local reports.