"Florence is. expected to remain an extremely risky major hurricane through Thursday", the hurricane center warned.
Florence is so wide that a life-threatening storm surge was being pushed 300 miles ahead of its eye, swirling clouds that could deluge states from SC to OH and Pennsylvania as it slows and then stalls over land.
North Carolina's governor issued what he called a first-of-its-kind mandatory evacuation order for North Carolina's fragile barrier islands from one end of the coast to the other.
North Carolina Governor Roy Cooper told a news conference his state was in "the bull's eye".
Trump says the federal government is "absolutely, totally prepared".
The governors of North and SC and Virginia declared states of emergency far ahead of the approaching storm.
Trump said the hurricane was "one of the worst storms to hit the East Coast in many years".
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By 11pm Monday (Tues afternoon NZT), Florence was centered about 1,745 kilometres east-southeast of Cape Fear, North Carolina, and moving west at 20 km/h.
All inland residents should find out now if you live in a flood prone area.
Hurricane Florence is plowing toward the East Coast as a Category 4 storm with a 500-mile wing span, forcing dire warnings and mandatory evacuations - including the entire coastline of SC and parts of Virginia and North Carolina. "Don't wait", said Greg Postel, a hurricane expert at the Weather Channel.
A hurricane hunter plane found Florence strengthening quickly, reaching top winds of 85 miles per hour (140 kph) Sunday evening after crossing the 74 miles per hour threshold from tropical storm to a hurricane earlier in the day.
Isaac is moving at 16 miles per hour, and is not expected to slow down, so hopefully the rains won't cause too much flooding on Dominica and surrounding islands. The latest Category 4 to hit the Carolinas was Hurricane Hazel in 1954. During that time, 40 to 70mph sustained winds are possible with hurricane force gusts up to 80mph.
"There is an increasing risk of two life-threatening impacts from Florence: storm surge at the coast, freshwater flooding from a prolonged and exceptionally heavy rainfall event inland, and damaging hurricane-force winds", the NHC warned. "We know we can't play around with this", said Jennifer Oosterwyk, who owns the Sugar Britches boutique on Holden Beach and lives in nearby Wilmington.
Isaac is expected to reach landfall in the Caribbean later this week.
"A turn toward the northwest is forecast to occur late Wednesday night", the 5 p.m. update stated.