At least four people were killed and many more injured Tuesday when a massive tornado hit Mississippi, WDAM-TV, Hattiesburg, reported. Marion County Hospital, which suffered damage from the storm, was inundated with people seeking help. The Mississippi hospital initially treated 50 patients, transporting eight with severe injuries to Forrest General Hospital in Hattiesburg, WDAM reported.

tornado watch was extended for areas of southeast Louisiana and Gov. Phil Bryant of Mississippi issued a state of emergency for Marion and Jones counties. Karla Brown with the Marion County Sheriff’s Department told the Huffington Post the tornado “was a very large one” and caused significant damage. There were reports of people trapped inside structures and vehicles, Brown told the Huffington Post.

A 6 p.m. to 6 a.m. curfew was in effect, WDAM reported.

The storm moved across the Southeast Tuesday morning, producing golf ball-size hail in Louisiana, the New Orleans Times-Picayune reported. The funnel cloud formed Tuesday afternoon near Amite City, Louisiana, and then moved on to Columbia, Mississippi, taking down trees, buildings and power lines in its path, WAPT, Jackson, reported. Mississippi Power reported all but three of its 3,638 customers were without electricity in Columbia late Tuesday afternoon. Several businesses, including a Walmart and a children’s day care, were reported “completely collapsed” in Mississippi, WDAM reported.

Multiple tornadoes ripped through northern Mississippi just eight months ago, killing 10 people and injuring more than 80 in April. The second deadliest tornado in U.S. history struck Natchez, Mississippi, and parts of Louisiana May 6, 1840, killing 317 people, according to the National Climatic Data Center.

Climate change increases the likelihood of weather-related natural disasters and will very likely impact future catastrophes, the NASA Earth Observatory predicts. Margareta Wahlstrom, a top official on natural disasters for the United Nations, warned of more natural disasters to come. “Everywhere, things are going on that didn’t go on 10 years ago,” Wahlstrom told the New York Times Tuesday. “Expect events to happen that you have never seen before. There will be no letup in the coming decades.” Wahlstrom will be in Thailand Friday for the 10th anniversary of the Indian Ocean tsunami that killed more than 227,000 people.