Hurricane Dorian, which has already devastated large parts of the Bahamas this week, has made landfall in the United States for the first time with winds of up to 90mph.

The category one storm came ashore on Friday morning at Cape Hatteras on the Outer Banks of North Carolina, where more than 200,000 homes and businesses in the state were without power.

Slow-moving Dorian slammed into the Bahamas last Sunday when it was at maximum category five strength with winds of 185mph and 220mph gusts.

At least 30 people have been killed in the island nation of nearly 400,000, and up to 13,000 homes were destroyed but authorities said the final number of dead could be “staggering”.

Hundreds, possibly thousands, of people are missing and the destruction was said to be “apocalyptic”. One of the worst-hit areas was the Abaco Islands.

Video footage from the town of Marsh Harbour on Great Abaco Island showed workers in white protective suits and wearing face masks and rubber globes searching through the rubble for victims. They placed body bags on to a truck.

Bahamas health minister Duane Sands said of the final death toll: “Let me say that I believe the number will be staggering.

“I have never lived through anything like this and I don’t want to live through anything like this again.”

The United Nations said at least 76,000 people are in need of urgent aid and a $5.4m (£4.3m) fund has been made available through the World Food Programme to begin providing emergency meals and other supports.

But distribution will be a challenge amid the destruction, and the scale of the task remains daunting for rescuers.

“It’s very unusual for 20% of the population of a country to be very severely impacted by a single event like this,” said UN relief chief Mark Lowcock.

The British Government has pledged £1.5m to help deliver aid, saying several hundred British nationals are thought to live in the worst affected areas.

The Royal Navy has provided emergency shelter and hygiene kits for hundreds of people, more than 8,000 bottles of water and hundreds of days’ worth of food.

After remaining over the Bahamas for days, Dorian moved north, sweeping past Florida and Georgia before leaving a path of destruction in South Carolina, where at one point more than 250,000 homes and businesses did not have power.

There have been at least four storm-related deaths in the US.

The hurricane has been skimming along North Carolina’s coast at about 14mph, according to the National Hurricane Centre, which warned “life-threatening storm surge” and dangerous winds were expected, along with large and destructive waves.

Resident Leslie Lanier said Ocracoke Island in the state’s Outer Banks was “flooding like crazy” and the water level has hit the first floor of some buildings.

Northeastern North Carolina is expected to get an extra three to eight inches (7cm to 20cm) of rainfall, with up to 15 inches (38cm) in some isolated areas.

The hurricane centre warned tornadoes were also possible across eastern North Carolina into southeastern Virginia on Friday.

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