About 400 people were taken to hospitals after the accident, which happened in eastern India, about 137 miles southwest of Kolkata, officials said. The cause was under investigation.
Ten to 12 coaches of one train derailed, and debris from some of the mangled coaches fell onto a nearby track, said Amitabh Sharma, a railroad ministry spokesperson.
The debris was hit by another passenger train coming from the opposite direction, and up to three coaches of the second train also derailed, Sharma said.
The Press Trust of India news agency reported that a third train carrying freight was also involved, but there was no immediate confirmation from railroad authorities.
In the aftermath, television images showed rescuers climbing atop the wreckage to break open doors and windows and using cutting torches to free survivors.
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Passenger Vandana Kaleda told the New Delhi Television news channel that she found people falling on each other as her coach shook violently and veered off the tracks. She said she was lucky to survive.
Another survivor who did not give his name said he was sleeping when the impact woke him up. He said he saw other passengers with broken limbs and disfigured faces.
Dattatraya Bhausaheb Shinde, the top administrator in the Balasore district, said at least 50 people were dead. The Press Trust reported a death toll of at least 70.
Nearly 500 police officers and rescue workers with 75 ambulances and buses responded to the scene, said Pradeep Jena, the top bureaucrat of the Odisha state.
Rescuers were attempting to free 200 people feared trapped in the wreckage, Shinde said.
The Press Trust said the derailed Coromandel Express was traveling from Howrah in West Bengal state to Chennai, the capital of southern Tamil Nadu state.
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Indian Prime Minister Narendra Modi said his thoughts were with the bereaved families.
“May the injured recover soon, tweeted Modi, who said he had spoken to the railway minister and that all possible assistance was being offered.
Despite government efforts to improve rail safety, several hundred accidents occur every year on Indias railways, the largest train network under one management in the world.
In August 1995, two trains collided near New Delhi, killing 358 people in the worst train accident in Indias history.
Most train accidents are blamed on human error or outdated signaling equipment.
More than 12 million people ride 14,000 trains across India every day, traveling on
64,000 kilometers (