At least two Carnival Cruise clients were killed and five others were injured when their coach crashed during a shore excursion in Belize.
Americans Jacqueline Abad, 53, and Sara Armijo, 51 died after the minivan they were traveling in was in a head on collision with an SUV.
The three occupants of the SUV also died.
There are also unconfirmed reports of possibly a third American fatality and the van driver is understood to have died also.
Carnival Cruise Line confirmed seven of its guests were involved in the accident during the tour which was booked independently.
They are thought to be guests on Carnival Vista which is on a seven-day sailing that departed from Galveston on November 23.
At least five other Americans suffered various injuries ranging from fractures, broken limbs and cuts.
"Along with Carnival guests, there were guests from at least one other cruise line on the bus. Sadly, two guests have died and the five others remain hospitalised, with one guest already transported back to the US for medical care," the cruise line said.
