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Moore, Oklahoma (CNN) -- Even for a city toughened by disaster, Moore has never seen this kind of devastation.
A massive, howling tornado pulverized a vast swath of the Oklahoma City suburb Monday, chewing up homes and businesses, and severely damaging a hospital and two elementary schools.
The storm killed at least 91 people. The official death toll stood at 51 Tuesday morning, but a coroner's office official said some 40 bodies have yet to be processed by medical examiners -- roughly half of them children. More bodies could be hidden under the vast debris field, authorities warned.
Hundreds of people were injured.
Photos: Tornadoes wreak havoc in Midwest
Tornado leaves path of destruction
Rescue efforts continue at school
Tornado survivor: I just want to cry
Firefighters, police, National Guard members and volunteers worked by flashlight overnight and into Tuesday morning, crawling across piles of debris in a determined search for survivors and victims. Air National Guard members brought in thermal imaging equipment to aid in the search.
More than 100 people had been pulled from the rubble alive since Monday afternoon, the state Highway Patrol said.
Early Tuesday, authorities asked news crews to move satellite trucks from the scene because the idling engines were making it difficult for rescuers to listen for the faint sounds of survivors beneath the rubble.
"We're a tough state. This is a tough community," Lt. Gov. Todd Lamb told CNN on Tuesday. "There is hope. We always have hope. We always have faith."
At least 20 of those killed were children, including seven from Plaza Towers Elementary School in Moore, the site of a frantic search since Monday afternoon.
Impact Your World: Helping with disaster in the heartland
The school was in the direct path of the storm. About 75 students and staff members were hunkered down in Plaza Towers when the tornado struck, CNN affiliate KFOR reported.
At one point, an estimated 24 children were missing from the school, but some later turned up at nearby churches. Moore Mayor Glenn Lewis told CNN on Tuesday morning that he had been told four people remained unaccounted for.
On Monday, a father of a third-grader still missing sat quietly on a stool outside. Tears cascaded from his face as he waited for any news.
Even parents of survivors couldn't wrap their minds around the tragedy.
"I'm speechless. How did this happen? Why did this happen?" Norma Bautista asked. "How do we explain this to the kids? ... In an instant, everything's gone."
Briarwood Elementary School also suffered a hit, KFOR reported.
Get the latest developments in the story
Across town, Moore Medical Center also took a direct hit.
"Our hospital has been devastated," Mayor Glenn Lewis said. "We had a two-story hospital, now we have a one. And it's not occupiable."
So 145 of the injured were rushed to three other area hospitals.
That number includes 45 children taken to the children's hospital at Oklahoma University Medical Center, Dr. Roxie Albrecht said. Has ranged from minor to severe, including impalement and crushing injuries.
Tornado's are pretty common in this area of the US during this time of year, but this was one of the deadliest outbreaks in history. If you haven't had a chance to check out some of the pictures, you should because some of them are absolutely horrifying.
Two-mile-wide tornado slams Oklahoma City area, killing at least 51 - CNN.com
And I found this picture on another website...
Can you imagine how smart this survivor felt after he came out of this underground storm shelter this morning? And I'll bet anything at least one person called him crazy when he installed this thing under his house.
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