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Three people died and thousands of homes were left without electricity as the hurricane hit Cuba.
Hurricane Sandy continues to gain strength, upgraded to a category two overnight as it hit eastern Cuba early Thursday.
Winds up to 105 mph ripped roofs off houses, blew over trees and damaged coffee and tomato crops across the city of Santiago de Cuba.
GlobalPost's correspondent in Cuba, Nick Miroff, reported that power and phone lines are down in much of the region, and there are fears that the storm has damaged thousands of homes and buildings.
The 500-year-old colonial city has many historic structures in disrepair and homes in a dilapidated state. Local state radio broadcasts have reported at least one fatality in the nearby city of Palma Soriano, and one official government blogger has reported dozens of injuries in the city of Santiago. A Cuban weather station on a mountaintop outside Santiago recorded gusts topping 150 miles per hour before it too was knocked offline.
The eastern Cuban provinces of Camaguey, Las Tunas, Holguin, Granma and Guantanamo were also hit. State television broadcast images of downed trees, partly collapsed buildings and debris in the streets of Guantanamo.
"It crossed the entire eastern region practically without losing intensity or structure," said Jose Rubiera, the island's chief meteorologist, The Associated Press reported.
A woman in western Haiti's Camp-Perrin died Wednesday when she tried to cross a flooding river in the Ravine du Sud, according to Haitian news agency AHP, and CNN affiliate TV J reported a man in Jamaica was killed when he was hit by a boulder sent tumbling downhill by the storm's rain, CNN reported.
Later, Agence France Presse updated the death toll to three people killed.
Reuters reported the storm would maintain its intensity, and a tropical storm warning was in place along the south-eastern Florida coast, the Upper Keys and Florida Bay. Hurricane warnings remain in place for Jamaica, eastern Cuba, the Bahamas and Florida Bay.
Reuters said a Cuban television reporter, reporting by telephone from the communist island's second largest city, Santiago de Cuba, said the roaring winds had left the city "completely dark" and created a tense situation.
Heavy rains continued and strong winds had toppled many trees as residents waited nervously for it to pass.
The storm did not impact the US naval base at Cuba's Guantanamo Bay, but it knocked out power lines, which affected 5500 people living on the base. Officials said there was no threat to the 166 prisoners.
Meteorologists warned that Sandy may combine with other weather systems to create a major storm over the northeastern US next week.
Disaster experts said mid-Atlantic and Northeastern states could face heavy rains that trigger flooding, with some forecasters even suggesting that Sandy could be a multi-billion dollar disaster more powerful than last year's Hurricane Irene.
They said it was too soon to tell if the hurricane had the power and trajectory to lead to that worst-case scenario, according to Reuters. However, there are concerns it could join with another storm approaching the eastern coast, a "nor'easter."
Irene cost $4.3 billion in losses last year, and is ranked as one of the ten costliest hurricanes ever.
Hurricane Sandy has killed many more in Haiti. Where is the media getting their numbers?