The pileup in Espirito Santo state also left 13 people injured, the security services said. It was the third major road accident in Brazil this month.
The injured were taken to hospital in Guarapari, near the site of the tragedy, the state security department said. Thirteen of the dead were in the bus, while the other victims were in the ambulances and truck.
About 47,000 people die on Brazil's roads each year, according to 2013 figures from the World Health Organization.
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