Hurricane Dorian has strengthened as it works its way up the U.S. coast after causing widespread devastation in the Bahamas.

The storm, which has left 70,000 people in need of humanitarian relief according to the UN, is now expected to hit the U.S. states of Georgia, North Carolina, South Carolina and Georgia.

The death toll after the most damaging storm ever to strike the island nation now stands at 20 people, after it hit as a highest-level Category 5 storm, Bahamas Prime Minister Hubert Minnis said.

“We expect that this number will increase,” Minnis told a news conference as the scope of the destruction and humanitarian crisis was still coming into focus.

Mark Lowcock, United Nations under secretary-general for humanitarian affairs, said in a conference call from the Bahamas that people needed food, shelter and medical assistance.

“There is concern that some whole communities’ locations have been destroyed or are underwater or washed away,” he said.

“One of the uncertainties is where the people who were living there are now and how to reach them.”

Aerial video of the worst-hit Abaco Islands in the northern Bahamas showed widespread devastation, with the harbour, shops and workplaces, a hospital, and airport landing strips damaged or blown to pieces, all of which is frustrating rescue efforts.

In the United States, South Carolina was preparing for a record storm surge, potentially reaching a height of 8 feet (2 meters) at the popular vacation destination of Myrtle Beach, the U.S. National Hurricane Center (NHC) said in an advisory.

South Carolina is also likely to suffer major flooding with the potential for over a foot of rain in places when Dorian hits the coast on Thursday or Friday, the centre said.

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