As the driver lost control after one of the front tyres burst, the cracker-laden lorry hit the road median and collided with a Thiruvananthapuram-bound bus coming from the opposite direction on the four-lane highway, they said.
An 80-year old passenger of the bus died while 20 others were injured and admitted to the government hospital here, the police said.
The lorry also crushed to death a 33-year old woman, who was walking by the roadside. It then rammed into a tea shop, injuring its 55-year-old owner, and then overturned, they said.