Ferocious winds and rain are battering Florida as Hurricane Jeanne whips across the US state, the fourth major hurricane to strike in six weeks.
Jeanne's gusts of 100 mph (160km/h) are knocking down power lines, ripping off roofs and whirling up debris left behind by the last storm.
Orlando and Fort Lauderdale are among cities at risk of flooding.
Earlier, Jeanne battered the Bahamas with violent winds, sending hundreds of people fleeing to emergency shelters.
Jeanne's destructive power was already clear from the devastation in Haiti, where more than 1,500 were killed in flooding and landslides.
Hospital damaged
The hurricane, a dangerous category three storm, came ashore near Stuart, Fort Pierce and Vero Beach on Florida's east coast - the same region battered by Hurricane Frances three weeks ago.
"
Everyone in Florida is fed up. Jeanne is expected to hit Broward where I live very hard but I've noticed that people are not taking this seriously
"
Chrissybil Boulin, Pembrook Pines
A hospital in Stuart lost part of its roof as the winds roared overhead, causing water to leak into the building, officials said.
Patients were moved to other floors, but no injuries were reported.
Extensive damage is being reported as Jeanne travels north, snapping electricity lines that in some cases had only just been repaired.
Up to one million people are without power.
At 1100 GMT on Sunday, the centre of the hurricane was about 80km (50 miles) south of Orlando - one of Florida's top tourist destinations.
Jeanne - which has weakened slightly since coming ashore - is expected to turn north over central Florida before heading towards Georgia and the Carolinas.
Stunned disbelief
The BBC's Daniel Lak in Miami says it is too early to assess the damage, but the cumulative effect of Florida's four hurricanes will be immense.
Insurance claims were already expected to be in excess of $18bn, without factoring in the damage from Jeanne.
The hurricanes have so far caused at least 70 deaths in Florida.
State authorities said more than 31,000 people had taken to shelters on Saturday, many of them people whose homes had been damaged by Frances.
"People here are tired," emergency management spokeswoman Yvonne Martinez of Brevard County told Reuters news agency.
"A lot of them decided to ride out the storm at home and didn't evacuate. That's not really a good idea."
No other state has been hit by four hurricanes in the same season since Texas more than a century ago.
Florida resident George Robertson-Burnett told BBC News Online: "There is a stunned sort of disbelief that this can be happening.
"Never in living memory... has there been a sequence of hurricanes to match what is now happening."
On Saturday the Bahamas took the full impact of Jeanne's onslaught.
Several areas were flooded on both Abaco and Grand Bahama island - some up to 5ft (1.5m) deep.
Grand Bahama's airport, which was flooded three weeks ago when Hurricane Frances hit, is again under water.
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