America's deadliest tornado in almost six decades has killed at least 89 people as it cut a path of destruction, wrecking 2,000 buildings, including a hospital with almost 200 patients.
The twister, which hit Joplin, Missouri, on Sunday afternoon, left flames and thick black smoke pouring out of the debris as people searched for friends and neighbours. The injured were taken to makeshift emergency centres in pick-up trucks.
The town's fire chief, Mitch Randles, whose home was destroyed, said yesterday 30pc of Joplin, which has a population of 50,000, was damaged. "It cut the city in half," he said.
The 50mph twister left a trail of devastation six miles long and half a mile wide. Among the ruined buildings were houses, churches, schools and shops, and mangled cars and splintered trees littered the landscape. Winds from the storm carried debris 60 miles away.
With many of the city's restaurants full for lunch when the tornado struck, many bodies were found near the most popular establishments.
An unknown number of people were injured and officials said they expected the death toll to rise.
The city's residents were given about 20 minutes to get to safety when warning sirens sounded, but many were unable to shelter in time.
Jeff Law (23), who hid in a storm cellar, said: "It's like Armageddon. I've lived in this neighbourhood my entire life and I didn't know where I was. Everything was unrecognisable."
Scott Meeker, a journalist with 'The Joplin Globe', said: "It's a war zone. We've got hundreds of wounded being treated, but they were quickly overwhelmed and ran out of supplies so they've opened up a local school as a triage centre."
Right in the path of the tornado was St John's Regional Medical Centre, which was caring for about 180 patients.
The hospital's roof was blown off and in the car park an emergency helicopter lay crushed on its side, its rotors torn apart.
Cars were crumpled into a mass of twisted metal, and medical records, X-rays and building insulation lay scattered.
Refrigerated trucks were brought in to serve as a makeshift morgue and several hundred people were forced to seek shelter and medical treatment in a concert hall.
Many of the city's schools were destroyed or damaged. Kerry Sachetta, the principal of Joplin High School, which was left in ruins, said: "You see pictures of World War Two, the devastation and all that with the bombing. That's really what it looked like."
Jay Nixon, the governor of Missouri, declared a state of emergency and sent in National Guard troops. He said fires from gas leaks were burning across the city.
President Barack Obama called the governor to "extend his condolences", the White House said.
Officials said America's last twister to cause such loss of life was in 1953. The storm in Worcester, Massachusetts, killed 90 people.
The Joplin tornado was one of 68 reported across seven Midwest states over the weekend.
An outbreak of twisters killed more than 300 people and caused damage costing more than $2bn (€1.4bn) to southern US states last month. (© Daily Telegraph, London)