A massive tornado that tore a 6-mile (10-kilometer) path across southwestern Missouri killed at least 89 people as it slammed into the city of Joplin, ripping into a hospital, crushing cars like soda cans and leaving a forest of splintered tree trunks behind where entire neighborhoods once stood.

Authorities warned that the death toll could climb as search and rescuers continued their work. Their task was made more miserable Monday morning as a thunderstorm with strong, gusty winds and heavy rain pelted part of the city with hail.

City manager Mark Rohr announced the number of known dead at a pre-dawn news conference outside the wreckage of a hospital that took a direct hit from Sunday's storm. Rohr said the twister cut a path nearly 6 miles (10 kilometers) long and more than a half-mile (a kilometer) wide through the center of town, adding that tornado sirens gave residents about a 20-minute warning before the tornado touched down on the city's west side.

Much of the city's south side was leveled, with churches, schools, businesses and homes reduced to ruins. Fire chief Mitch Randles estimated 25 percent to 30 percent of the city was damaged, and said his own home was among the buildings destroyed as the twister swept through this city of about 50,000 people some 160 miles (260 kilometers) south of Kansas City.