Five people are known to have been killed and at least 35 injured by tornadoes in Iowa, officials have said.

The Iowa Department of Public Safety said the number of casualties is expected to rise after a tornado hit the small city of Greenfield on Tuesday.

Four people died in Greenfield, a city of 2,000 inhabitants about 55 miles southwest of Des Moines, while a fifth person died when her car was swept away in the wind about 25 miles away.

She has been named as Monica Zamarron, 46.

The tornado left a swath of obliterated homes, splintered trees and crumpled cars in Greenfield and crews were searching through mounds of debris on Wednesday to be sure no victims remained buried.

“It’s still a search mission as far as we’re looking to be sure all residents are accounted for,” said Iowa State Patrol Sargeant Alex Dinkla.

Greenfield’s 25-bed hospital was among the damaged buildings and at least a dozen people who were hurt had to be taken to facilities elsewhere.

Severe Weather Iowa
People examine damage after the tornado ripped through Greenfield, Iowa (Hannah Fingerhut/AP)

In a Facebook post, hospital officials said the hospital would remain closed until it could be further assessed and that full repairs could take weeks or months.

With the help of other providers, the hospital set up an urgent care clinic at an elementary school with primary care services to start there on Thursday, the post said.

The twister also ripped apart and crumpled massive power-producing wind turbines several miles outside the town.

White House Press Secretary Karine Jean-Pierre said the Federal Emergency Management Agency’s administrator would head to Iowa on Thursday and that the White House was in touch with state and local officials.

Severe Weather Iowa
The remains of two tornado-damaged wind turbines touch the ground in a field near Prescott, Iowa (Charlie Neibergall/AP)

She said they were “praying for those who tragically lost their lives” and wished those injured a “speedy recovery.”

Storms pummeled parts of Illinois and Wisconsin later on Tuesday, knocking out power to tens of thousands of customers. The severe weather turned south on Wednesday and the National Weather Service issued tornado and flash flood warnings in Texas as parts of the state—including Dallas—were under a tornado watch.

Tuesday’s destructive weather also saw flooding and power outages in Nebraska, damage from tornadoes in Wisconsin and Minnesota, and dust storms in Illinois that forced two interstates to be closed.

AccuWeather chief meteorologist Jon Porter said the tornado appeared to have been on the ground for more than 40 miles.

Severe Weather Iowa
Local residents clean up debris from tornado damaged homes in Greenfield (Charlie Neibergall/AP)

The deadly twister was spawned during a historically bad season for tornadoes in the US when climate change is heightening the severity of storms worldwide. April had the second-highest number of tornadoes on record in the country.

According to NOAA’s Storm Prediction Center in Norman, Oklahoma, through to Tuesday, there have been 859 confirmed tornadoes this year, 27% more than the US sees on average. So far, Iowa has had the most, with 81 confirmed twisters.

On Tuesday alone, the National Weather Service said it received 23 tornado reports, with most in Iowa and one each in Wisconsin and Minnesota.