(Reuters) – At least five people were killed and about 60 transported to hospitals after a Pennsylvania Turnpike crash early Sunday involving a tour bus, two tractor-trailers and passenger vehicles.

The cause of the pileup in Mount Pleasant Township, about 40 miles (64 km) southeast of Pittsburgh, was under investigation.

“Coroner has confirmed five fatalities,” turnpike spokesman Carl DeFebo said on Twitter.

He said about 60 patients were transported to three area hospitals in Westmoreland County. An 86-mile stretch of the turnpike remained closed on Sunday from New Stanton to Breezewood exits, he said.

Video and photographs of the pre-dawn crash appeared to show it involved a bus, two tractor-trailers as well as passenger vehicles.

Reporting by Barbara Goldberg in New York; Editing by Lisa Shumaker