At least 102 people have been killed by Hurricane Matthew, with the death toll in Haiti alone rising to 98, local officials say, as the storm headed northward to batter the Bahamas en route to Florida.
Haiti's civil protection service on Thursday put the toll in the impoverished Caribbean nation at 23 dead, many killed by falling trees, flying debris and swollen rivers.
The interior ministry, a local mayor and other local delegates earlier confirmed 75 other deaths to Reuters across Haiti.
That included a group of 24 people killed in the coastal town of Roche-a-Bateau.
"I've never seen anything like this," said the town's delegate Louis Paul Raphael.
Four people were killed earlier in neighbouring Dominican Republic.
Hurricane Matthew is expected to strengthen as it approaches Florida's heavily populated Atlantic coast.
The US National Hurricane Center in Miami says Matthew, though still a dangerous Category 3 hurricane as the day dawned, is expected to regain status as an even more powerful Category 4 storm in coming hours.
Top sustained winds ratcheted up from 185km/h to over 200km/h overnight.
As the threat from the hurricane rose along the south east seacoast a hurricane warning was extended to an area on a large swath of Florida's east coast farther up to Altamaha Sound, Georgia.
A newly expanded hurricane watch area would now reach from the Altamaha Sound to the South Santee River in South Carolina.
As Matthew put the US in its sights, about 2 million people were encouraged to head inland ahead of the most powerful storm to threaten the Atlantic coast in more than a decade.
The storm is forecast to near the Florida coast from Thursday night (local time), potentially as a Category 4 storm with 209km/h winds. Any slight deviation could mean landfall or it heading farther out to sea.
Either way, forecasters say it will come close enough to wreak havoc along the lower part of the East Coast, dumping up to 40cm of rain in some spots.
A storm surge of 2.5 metres was expected along the coast from central Florida into Georgia.
Reuters / AP