As the temperature drops, risk of fracture rises

Record-setting winter weather in the U.S. has led to lots of road condition advisories, but could there also be a slip and fall alert?

By analyzing various conditions -- like snow, wind speed, temperature -- into a 'Slipperiness Score,' a University of Michigan Health System study helps identify what days are the most risky for slip and fall injuries.

The study, published in February's Plastic and Reconstructive Surgery Journal, focuses on Medicare patients, all over age 65, but authors note, the risk of falling exists for anyone during harsh winter weather.

"Although the concept that slippery footing increases your risk of falling isn't new, what we've been able to show is that these dangerous conditions result in more fractures in this already vulnerable population of adults," says lead study author Aviram Giladi, M.D., a resident in the U-M Department of Surgery's Division of Plastic Surgery.

The study findings include:

Based on a scale, ranging from 0 to 7, on a day with a score above 4 the risk of sustaining a wrist fracture increased by 21 percent.On the most slippery days, that additional risk went up to nearly 40 percent.In the winter, over 1,000 additional wrist fractures occurred among adults age 65 and older compared to other seasons.

Nearly 90,000 Medicare enrollees sustain wrist fractures each year, frequently from falls while standing and usually outdoors. The fractures can be quite limiting, and lead to a loss of independence for older patients. Medicare spends more than $240 million a year treating the injuries.

"Understanding the risk of these injuries can help inform prevention and preparation efforts, especially on days where the weather is bound to result in more slippery conditions," says senior study author Kevin C. Chung, M.D., professor of plastic surgery and orthopedic surgery and the Charles B. G. de Nancrede Professor of Surgery. "We hope to help people prepare for risky conditions and adjust where and when they walk outdoors."

Journal Reference:

Aviram M. Giladi, Melissa J. Shauver, Allison Ho, Lin Zhong, H. Myra Kim, Kevin C. Chung. Variation in the Incidence of Distal Radius Fractures in the U.S. Elderly as Related to Slippery Weather Conditions. Plastic and Reconstructive Surgery, 2014; 133 (2): 321 DOI: 10.1097/01.prs.0000436796.74305.38

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This year's Harvest Moon rises Sept. 29

NASA/Sean Smith

A full moon captured July 18, 2008.

NASA/Sean Smith

A full moon captured July 18, 2008.

If you've ever wondered what, exactly, a harvest moon looks like, poke your head outside Saturday. That's when this year's harvest moon will rise.

The harvest moon is the full moon closest to the autumnal equinox,

which this year was on Sept. 22.

It's different from the other full moons because it rises at roughly the same time for several nights running, giving more light.

"In the days before tractors with headlights, having moonlight to work by was crucial to getting the harvest in quickly before rain caused it to rot," says Alan MacRobert, an editor at Sky &Telescope magazine.

The harvest moon will rise this year at 11:19 p.m. ET.

On average, the moon rises 50 minutes later each day than it did the day before. However, at this time of year, because of the angle of the moon as it orbits Earth, "the moon is rising at roughly the same time it rose the night before," says Ed Krupp, director of the Griffith Observatory in Los Angeles.

So for about three days in a row, the full moon is coming up just after the sun sets.

"This brings a great deal of light into the early evening sky, which was important for the people harvesting because it extended the period of useful work time they could work in the fields," Krupp says.

The moon may look bigger and seem closer, but it's not, says David DeVorkin, a senior curator at the Air and Space Museum in Washington, D.C. Generally, photos of harvest moons are taken with telephoto lenses, distorting the size. The harvest moon can appear more reddish, though, because of coloration caused by dust in the atmosphere, but it depends on where you are.

The change in the time of moonrise "has to do with the angle along which the moon is traveling in its orbit," Krupp says. At the fall equinox, "the angle is very shallow, so it doesn't go so far below the horizon and as a result comes up again at about the same time."

The harvest moon isn't the only one to have a name, though few are remembered now. The new moon after the harvest moon was typically called Hunter's moon, because it aided hunters stalking night game as fall deepened.

For more information about reprints & permissions, visit our FAQ's. To report corrections and clarifications, contact Standards Editor Brent Jones. For publication consideration in the newspaper, send comments to letters@usatoday.com. Include name, phone number, city and state for verification. To view our corrections, go to corrections.usatoday.com.

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This year's Harvest Moon rises Sept. 29

NASA/Sean Smith

A full moon captured July 18, 2008.

NASA/Sean Smith

A full moon captured July 18, 2008.

If you've ever wondered what, exactly, a harvest moon looks like, poke your head outside Saturday. That's when this year's harvest moon will rise.

The harvest moon is the full moon closest to the autumnal equinox,

which this year was on Sept. 22.

It's different from the other full moons because it rises at roughly the same time for several nights running, giving more light.

"In the days before tractors with headlights, having moonlight to work by was crucial to getting the harvest in quickly before rain caused it to rot," says Alan MacRobert, an editor at Sky &Telescope magazine.

The harvest moon will rise this year at 11:19 p.m. ET.

On average, the moon rises 50 minutes later each day than it did the day before. However, at this time of year, because of the angle of the moon as it orbits Earth, "the moon is rising at roughly the same time it rose the night before," says Ed Krupp, director of the Griffith Observatory in Los Angeles.

So for about three days in a row, the full moon is coming up just after the sun sets.

"This brings a great deal of light into the early evening sky, which was important for the people harvesting because it extended the period of useful work time they could work in the fields," Krupp says.

The moon may look bigger and seem closer, but it's not, says David DeVorkin, a senior curator at the Air and Space Museum in Washington, D.C. Generally, photos of harvest moons are taken with telephoto lenses, distorting the size. The harvest moon can appear more reddish, though, because of coloration caused by dust in the atmosphere, but it depends on where you are.

The change in the time of moonrise "has to do with the angle along which the moon is traveling in its orbit," Krupp says. At the fall equinox, "the angle is very shallow, so it doesn't go so far below the horizon and as a result comes up again at about the same time."

The harvest moon isn't the only one to have a name, though few are remembered now. The new moon after the harvest moon was typically called Hunter's moon, because it aided hunters stalking night game as fall deepened.

For more information about reprints & permissions, visit our FAQ's. To report corrections and clarifications, contact Standards Editor Brent Jones. For publication consideration in the newspaper, send comments to letters@usatoday.com. Include name, phone number, city and state for verification. To view our corrections, go to corrections.usatoday.com.

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Japan storm death toll rises to 25, more missing (Reuters)

TOKYO (Reuters) – Japan's death toll from tropical depression Talas, earlier downgraded from a tropical storm, has risen to 25 with 52 missing, the government said Monday, as torrential rain pounded the west of the country at the weekend, triggering mudslides and bursting river banks.

Talas, which cut through Japan's main island Saturday and Sunday, was off the country's western coast as of 8:00 p.m. EDT, heading northeast, the Japan Meteorological Agency (JMA) said.

There were no reports of major disruption to factory operations and Tokyo Electric Power Co said its tsunami-crippled Fukushima Daiichi nuclear power plant, located in eastern Japan, has not been affected by the storm.

Talas has mostly moved at about 6 mph, roughly the speed of a bicycle, and its slow progress caused heavy and prolonged rainfall over Japan, the agency said.

"We'll do our utmost in terms of search and rescue operations," Prime Minister Yoshihiko Noda told reporters when asked about the disaster.

As Talas moves on, heavy rain is expected in the north of the country, though JMA warned residents of the west to remain on alert for landslides.

(Reporting by Kiyoshi Takenaka; Editing by Joseph Radford)

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Kansas town rises green from tornado rubble (Reuters)

GREENSBURG, Kansas (Reuters) – When community leaders in tornado-ravaged places such as Joplin, Mo., consider the future, they look to Greensburg, Kansas.

Destroyed by a powerful tornado on May 4, 2007, Greensburg is renowned for its rebirth as a community of sustainable living. The town has energy-saving buildings and landscaping at every turn, drawing curious public officials and tourists from around the world.

"Greensburg is certainly a great story," said Steve Castaner, a long-term recovery manager for the Federal Emergency Management Agency. "It's a laboratory for how you can take advantage of opportunities to reinvent yourself."

Next week, FEMA will host a "sustainable communities workshop" in Greensburg, attended by people from Joplin and two southeast U.S. communities recently damaged by tornadoes. They will learn how to follow Greensburg's example.

The EF-5 tornado destroyed 95 percent of Greensburg, a town of 1,600 in the flat farmland of south central Kansas. Almost immediately, city, state and community leaders talked about bringing Greensburg back green, said Mayor Bob Dixson.

Greensburg's population is down to about 800 because of a loss of housing stock and jobs, but it draws "a pilgrimage" of people who want to see sustainability at work, said Matt Deighton, a volunteer who gives tours of the town.

There is plenty to see.

The tornado destroyed many of the town's large trees, so wind turbines now outnumber them. The town has a ten-turbine wind farm. The hospital has its own turbine, as does the public school and even the Best Western motel, which has saved 50 percent on its utility bill.

"As far as I know, we are the only hotel in the United States with a wind power generator," said Ron Wright, owner of the Best Western Night Watchman Inn.

The new public school not only has a wind turbine but 97 wells dug 410 feet into the ground for a geothermal heating system that uses the 55-degree water to cool or warm air pumped into the building.

Like those of many buildings in town, the school's windows are sized and positioned to make best use of natural light and the sun's warmth.

The mayor had his house built with small windows on the north and larger ones elsewhere, and he used timber in four- or eight-foot lengths to reduce waste.

City Hall and several other buildings have rooftop solar panels to convert sunshine into electric power. Many homeowners have chosen to build energy-efficient houses.

In building anew, Greensburg used a lot of old materials. Bricks for the walls at city hall came from a power plant the tornado destroyed. The furniture store is made of bricks from the old store. Wood siding at the school came from trees damaged by Hurricane Katrina.

Rain is not wasted. All through town are systems for filtering and capturing rainwater, which is stored in underground cisterns for irrigation when the weather is dry.

Greensburg is building a museum to herald what used to be its biggest claim to fame -- the largest hand-dug well in the world -- but also to tell the story of its green rebirth.

Its slogan is that it is "Stronger. Better. Greener."

The community took advantage of various federal programs to build with sustainability in mind, but it took a spirit of public and private cooperation to be successful, Dixson said.

FEMA provided $80 million in subsidies for construction of city hall, the school and hospital, said Pam Reves, city treasurer. The U.S. Department of Energy and the National Renewable Energy Laboratory provided technical assistance and other guidance on sustainable construction in the public and private sector.

A key player is Greensburg GreenTown, a nonprofit organization that promotes green projects and gives tours. The town boasts the most LEED-certified buildings, a recognized system of measuring green projects, per capita in America.

The visit by officials from Joplin and the communities of Smithville, Miss. and Cordova, Ala., comes on the heels of an earlier visit by a delegation from Tuscaloosa, Ala., heavily damaged by a recent tornado.

Greensburg City Councilwoman Erica Goodman said Greensburg is ready with a message of hope for other communities.

"We can't tell you want to do," Goodman said. "We can only tell you what we have done and hopefully you can take that home and start your recovery."

(Writing and reporting by Kevin Murphy; Editing by Mary Wisniewski and Ellen Wulfhorst)

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Joplin tornado death toll rises to 154 (Reuters)

KANSAS CITY (Reuters) – The death toll from the May 22 tornado in Joplin, Missouri, has reached 154, according to a city statement on Friday.

That number is up from 153 reported by the city on June 13. The most recent victim was James Cookerly, city public information officer Lynn Onstot said with providing further information.

The massive F-5 tornado cut a six-mile swath through the southwest Missouri city just as residents were sitting down to Sunday dinner. It was the deadliest single tornado in the United States since 1947.

Tornadoes have battered the country this spring, killing more than 500 people, mostly in the south.

The death toll from the Joplin storm has risen as people die of injuries. Some have died due to a fungal infection from debris that contained soil or plant matter, officials have said.

(Edited by Peter Bohan)

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Joplin toll rises to 151; some suffer from fungus (AP)

JOPLIN, Mo. – The death toll from the tornado that destroyed much of Joplin has risen to 151, and three of the latest victims suffered from a rare fungal infection that can occur when dirt becomes embedded under the skin, authorities said Friday.

Jasper County Coroner Rob Chappel said the three had been hospitalized with the unusually aggressive infection sometimes found in survivors of other natural disasters. He said it was difficult to identify the fungus as a cause of death since the people infected also suffered other severe injuries.

"These people had multiple traumas, pneumonia, all kinds of problems," said Dr. Uwe Schmidt, an infectious disease specialist at Freeman Health System in Joplin. "It's difficult to say how much the fungal infections contributed to their demise."

Schmidt said his hospital treated five Joplin tornado victims for the infection, known as zygomycosis (zy'-goh-my-KOH'-sihs).

Jacqueline Lapine, a spokeswoman for the Missouri Department of Health and Senior Services, said the department has received reports of eight suspected deep-skin fungal infections among survivors of the May 22 twister. She said all of the victims had suffered multiple injuries and developed secondary wound infections.

Zygomycosis, also known as mucormycosis, is a sometimes-fatal infection that spreads rapidly and can be caused by soil or vegetative material becoming getting under the skin. It's more prevalent in people with weakened immune systems or untreated diabetes but can affect healthy people who get badly hurt.

Schmidt said he had seen only two cases of zygomycosis in his 30 years of practice, and both of those cases involved people with untreated diabetes.

Among the tornado survivors, some wounds that were stitched up had to be reopened because they had not been adequately cleaned, Schmidt said.

Overall infection numbers were not available. The health department in Springfield-Greene County, where some patients were treated, declined to release information about patients sickened by the fungus, citing patient privacy concerns.

The Springfield News-Leader reported that the department sent a memo Monday to area health providers warning them to be on the lookout for the infections.

In the aftermath of the tornado, Freeman Health System treated more than 1,700 patients. Doctors from St. John's Hospital, which was badly damaged by the twister, treated patients at makeshift facilities.

"These were very extensive wounds," Schmidt said. "They were treated in the emergency room as quickly as possible."

A week after the tornado, patients began arriving with fungal infections.

"We could visibly see mold in the wounds," Schmidt said. "It rapidly spread. The tissue dies off and becomes black. It doesn't have any circulation. It has to be removed."

Schmidt said the infection is sometimes seen in survivors of mass trauma such as the 2004 tsunami in Indonesia.

"This fungus invades the underlying tissue and actually invades the underlying blood vessels and cuts off the circulation to the skin," he said. "It's very invasive."

___

Information from: Springfield News-Leader, http://www.news-leader.com

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Joplin toll rises to 151; some suffer from fungus (AP)

JOPLIN, Mo. – The death toll from the tornado that destroyed much of Joplin has risen to 151, and three of the latest victims suffered from a rare fungal infection that can occur when dirt becomes embedded under the skin, authorities said Friday.

Jasper County Coroner Rob Chappel said the three had been hospitalized with the unusually aggressive infection sometimes found in survivors of other natural disasters. He said it was difficult to identify the fungus as a cause of death since the people infected also suffered other severe injuries.

"These people had multiple traumas, pneumonia, all kinds of problems," said Dr. Uwe Schmidt, an infectious disease specialist at Freeman Health System in Joplin. "It's difficult to say how much the fungal infections contributed to their demise."

Schmidt said his hospital treated five Joplin tornado victims for the infection, known as zygomycosis (zy'-goh-my-KOH'-sihs).

Jacqueline Lapine, a spokeswoman for the Missouri Department of Health and Senior Services, said the department has received reports of eight suspected deep-skin fungal infections among survivors of the May 22 twister. She said all of the victims had suffered multiple injuries and developed secondary wound infections.

Zygomycosis, also known as mucormycosis, is a sometimes-fatal infection that spreads rapidly and can be caused by soil or vegetative material becoming getting under the skin. It's more prevalent in people with weakened immune systems or untreated diabetes but can affect healthy people who get badly hurt.

Schmidt said he had seen only two cases of zygomycosis in his 30 years of practice, and both of those cases involved people with untreated diabetes.

Among the tornado survivors, some wounds that were stitched up had to be reopened because they had not been adequately cleaned, Schmidt said.

Overall infection numbers were not available. The health department in Springfield-Greene County, where some patients were treated, declined to release information about patients sickened by the fungus, citing patient privacy concerns.

The Springfield News-Leader reported that the department sent a memo Monday to area health providers warning them to be on the lookout for the infections.

In the aftermath of the tornado, Freeman Health System treated more than 1,700 patients. Doctors from St. John's Hospital, which was badly damaged by the twister, treated patients at makeshift facilities.

"These were very extensive wounds," Schmidt said. "They were treated in the emergency room as quickly as possible."

A week after the tornado, patients began arriving with fungal infections.

"We could visibly see mold in the wounds," Schmidt said. "It rapidly spread. The tissue dies off and becomes black. It doesn't have any circulation. It has to be removed."

Schmidt said the infection is sometimes seen in survivors of mass trauma such as the 2004 tsunami in Indonesia.

"This fungus invades the underlying tissue and actually invades the underlying blood vessels and cuts off the circulation to the skin," he said. "It's very invasive."

___

Information from: Springfield News-Leader, http://www.news-leader.com

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Death toll in Joplin tornado rises to 151 (AP)

JOPLIN, Mo. – The death toll from the tornado that destroyed much of Joplin has risen to 151 in part because of several deaths linked to a rare fungal infection.

Jasper County Coroner Rob Chappel said Friday that his office is still receiving regular reports of people who have died at hospitals after being hurt in the nation's deadliest tornado in more than six decades.

The most recent death was confirmed late Wednesday.

The updated death toll from the May 22 twister includes at least three hospital patients who became infected with zygomycosis (zy'-goh-my-KOH'-sihs), a severe fungal infection that can occur when soil gets under the skin.

Chappel says it is difficult to identify the infection as a cause of death since the people infected also suffered other severe injuries.

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Joplin, Mo., Tornado Death Toll Rises to 151 (ContributorNetwork)

The death toll from the deadliest tornado since modern record keeping began has climbed to 151 people. The May 22 twister claimed more lives from injuries, including Riverside police officer Jeff Taylor, who was struck by lightning the day after the tornado.

The death toll rose by 10 from the previous count Wednesday. The Springfield News-Leader reports Jasper County Coroner Rob Chappel stated the death toll had risen due to those in hospitals who died from their injuries. The news comes as Homeland Security Secretary Janet Napolitano and Gov. Jay Nixon prepare to tour the devastation. Television station KOLR reports Nixon will likely ask for more funding to help with relief efforts for uninsured homes and businesses.

The number of dead comes at a time when the city should be focused on rebuilding. Springfield News-Leader reports ore of the injured have died in hospitals, including at least two who succumbed to severe fungal infections. The gigantic EF5 tornado spewed fungus into the air from beneath the soil. When the tiny bits of fungus got into the bloodstream of victims who were bleeding, the infection quickly spread.

Patients with fungal infections may have survived their initial injuries but then couldn't fight off the invasive infection. Although rare, health officials issued a memo to all professionals caring for the wounded.

As the death toll stands now, the tornado is the seventh deadliest on record and the worst single twister since 1947. Official records were not kept until 1950. As many as 181 people died in Woodward, Okla., April 9, 1947, when a 100-mile long path of destruction was caused by an F5 tornado. The storm was part of an outbreak of six tornadoes in Oklahoma and Texas. The single deadliest tornado is still the Tri-State Tornado that struck Missouri, Illinois and Indiana in 1925. Almost 700 people lost their lives.

Southwest Missouri might have been spared the worst. The Joplin tornado was on the ground for only 13 miles and 20 minutes. Many F5 and EF5 tornadoes can last anywhere from 80 to 100 miles. If the massive tornado continued on the ground along Interstate 44, a metropolitan area of over a quarter million people would have been in the way of the 200 mph winds. Springfield, the third largest city in Missouri, is just 70 miles to the east of Joplin and would have been in the path of the storm.

For such a precise hit of only 13 miles long and a mile wide, the EF5 tornado was as rare and unusual as scientists feared when they surveyed the damage and the injured. Seventy miles more, and the tornado might have been the worst ever experienced by human beings.

William Browning, a lifelong Missouri resident, writes about local and state issues for the Yahoo! Contributor Network. Born in St. Louis, Browning earned his bachelor's degree in English from the University of Missouri. He currently resides in Branson.

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Joplin tornado death toll rises to 125 (AP)

JOPLIN, Mo. – Rescuers refused to be deterred from their efforts to find survivors beneath Joplin's jagged piles of tornado rubble, even as the death toll rose Wednesday to 125.

No new survivors had been pulled from the city's wrecked neighborhoods, but determined crews carried on with the search, checking some areas for a fourth time since Sunday's disaster. They planned to do a fifth sweep, too.

"We never give up. We're not going to give up," City Manager Mark Rohr told a news conference. "We'll continue to search as we develop the next phase in the process."

Rohr raised by three the death toll of the nation's deadliest single tornado in more than 60 years. The estimated number of injured climbed to more than 900.

At least 50 dogs have joined the search, and the teams were also using listening devices in hopes of picking up the faint sound of anyone still alive beneath the collapsed homes and businesses.

"We've had stories from earthquakes and tsunamis and other disasters of people being found two or three weeks later," Fire Chief Mitch Randles said. "And we are hopeful that we'll have a story like that to tell."

Searchers "try to get into every space. We're yelling. We've got the dogs sniffing. We've got listening devices," Randles said.

Meanwhile, roughly 100 people were reviewing information about individuals who were reported missing after the storm. Rohr said the group was making progress, but he declined to say how many remain unaccounted for.

Authorities have cautioned that people who are unaccounted for are not necessarily dead or trapped in debris. Many, if not most, of them probably survived the storm but have failed to tell friends and family where they are.

The Joplin tornado was the deadliest single twister since the National Weather Service began keeping official records in 1950. It was the eighth-deadliest in U.S. history.

Scientists said the system was an EF-5, the strongest rating assigned to tornadoes, with winds of more than 200 mph.

It also appeared to be a rare "multivortex" tornado, with two or more small and intense centers of rotation orbiting the larger funnel.

Bill Davis, the lead forecaster on a weather service team sent to survey the damage, said he would need to look at video to confirm that.

But, he said, the strength of the tornado was evident from the many stout buildings that were damaged: St. John's Regional Medical Center, a bank that was destroyed except for its vault, a Pepsi bottling plant and "numerous well-built residential homes that were basically leveled."

Davis recalled his first thought on arriving in town to conduct the survey: "Where do you start?"

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Tornado death toll rises, no more survivors found (Reuters)

JOPLIN, Mo (Reuters) – The death toll from a monster tornado that savaged Joplin, Missouri, rose to 125 on Wednesday and tornadoes overnight in nearby states caused at least 15 more deaths.

Three days after the deadliest single tornado in the United States in 64 years, rescue teams with dogs sifted through rubble in Joplin without finding anyone alive on Wednesday.

Authorities said the operation was still a search and rescue, but hope of finding more people alive was fading.

The number of people injured by the massive tornado was revised up to more than 900, according to local authorities, from 823 earlier in the day.

Officials were no longer saying how many people are missing because they believe the figure of 1,500 missing mentioned earlier in the week was inflated by double counting or people simply being out of town.

Some families continued a desperate search for missing loved ones amid the ruins of homes and businesses.

Fifteen-month-old Skyular Logsdon, whose blue teddy bear, red t-shirt and pants were found wrapped around a telephone pole after the storm, remains missing, his great grandmother told Reuters on Wednesday.

His injured parents were found and taken to a hospital after the tornado. But the little boy has vanished.

"We're still hopeful," said Deb Cummins, great grandmother of the missing boy. She said they have checked every possible hospital.

Another wave of tornadoes roared across the Midwest on Tuesday night, leaving nine dead in Oklahoma, four fatalities in Arkansas and two in Kansas, officials said.

In Newcastle, south of Oklahoma City, a storm blew the steeple off Jesus Alive Church and carried it nearly 100 yards away, where it landed on the doorstep of the longtime pastor's 86-year-old mother, Lovina Frizzell.

"I said 'Oh, my goodness, there's the steeple,'" Frizzell said as she swept her front porch.

In Oklahoma alone, seven tornadoes tore across the state overnight, according to the National Weather Service. The deadliest of those, which killed seven persons, left a 75-mile path of destruction and lasted two hours.

Oklahoma authorities said a 22-year-old man died in hospital of injuries from the storm, bringing the death toll in the state to nine.

Severe weather was continuing on Wednesday evening further east in Arkansas, Tennessee, Mississippi and north into Illinois and Indiana, although winds so far were not as threatening as on Tuesday night, according to meteorologists.

One funnel cloud struck Sedalia, Missouri, a town of 20,000 residents, on Wednesday afternoon, damaging homes and businesses, overturning vehicles, downing power lines and rupturing gas lines, emergency officials said.

Nervous Joplin residents were relieved after the threat of another tornado heading for the city proved to be false overnight.

The Joplin tornado on Sunday was rated an EF-5, the highest possible on the Enhanced Fujita scale of tornado power and intensity, with winds of at least 200 miles per hour.

EF-5 tornadoes are rare in the United States but already this year there have been at least four. They are so destructive that experts said they can turn a house into a missile.

Authorities in Joplin struggled to cope with the massive destruction. Some 14,000 customers in the city of 50,000 were still without power, water pressure was low in many homes and a local cable and cellphone provider had only about 20 percent of its customers back up and running normally.

A system of permits to allow residents back to their damaged homes and prevent looting was abandoned on Wednesday as long lines formed. Officials decided instead to keep a strong police and National Guard presence while allowing people free access to the miles of damaged neighborhoods.

This year has seen an unusually high number of tornadoes, with 1,168 as of May 22, compared to an average of about 671 by this time, according to Joshua Wurman, president of the Center for Severe Weather Research in Boulder, Colorado.

The U.S. is on pace to break the record for deaths from tornadoes this season, the National Weather Service has said.

(Writing by Carey Gillam and Greg McCune; Additional reporting by Suzi Parker, Steve Olafson, and Kevin Murphy; Editing by Peter Bohan)

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