In pictures: Hurricane Helene destruction

Hurricane Helene is one of the most powerful storms to hit the United States with wind gust speeds of 140 mph (225 km/h) and heavy rain.

The storm made landfall in Florida as a category four hurricane but was downgraded to a tropical storm as it moved more inland.

However, it was the strongest storm on record to hit Florida’s Big Bend and moved north into Georgia and the Carolinas after making landfall overnight on Thursday.

At least 45 people have died and millions have been left without power amid strong winds and flooding.

Insurers and financial institutions say damage caused by the storm could run into the billions of dollars.

Reuters Children walk past the collapsed portion of a bridge after flood waters destroyed it, in Boone, North Carolina — Children walk past the collapsed portion of a bridge after flood waters destroyed it, in Boone, North Carolina

A local resident helps free a car that became stranded in a stretch of flooding road on the outskirts of Boone, North Carolina.

Reuters A local resident helps free a car that became stranded in a stretch of flooding road on the outskirts of Boone, North Carolina. — A local resident helps free a car that became stranded in a stretch of flooding road on the outskirts of Boone, North Carolina.

Members of the fire department’s water rescue Team help a man in Atlanta, Georgia

EPA Members of the Atlanta Fire Rescue Department's Water Rescue Team rescue a man in Atlanta, Georgia — Members of the fire department’s water rescue Team help a man in Atlanta, Georgia

Across the region many would wake to find damage from flooding.

Flood waters wash over Guy Ford Road bridge on the Watauga River as Hurricane Helene approaches the North Carolina mountains

Jonathan Drake/Reuters Flood waters wash over Guy Ford Road bridge on the Watauga River as Hurricane Helene approaches the North Carolina mountains — Flood waters wash over Guy Ford Road bridge on the Watauga River as Hurricane Helene approaches the North Carolina mountains

Joe Raedle/Getty Images Flood waters in Tarpon Springs, Florida — Flood waters in Tarpon Springs, Florida

Peachtree Park Apartments resident Candice Ocvil (left) and Jibri Tolenrow KAYAK through flood waters in Peachtree Creek, Georgia

Erik Lesser/EPA-EFE Peachtree Park Apartments resident Candice Ocvil (left) and Jibri Tolenrow through flood waters from Peachtree Creek, Georgia — Peachtree Park Apartments resident Candice Ocvil (left) and Jibri Tolenrow KAYAK through flood waters in Peachtree Creek, Georgia

In Peachtree Creek some residents took to boats to navigate the flood water while another set about cleaning up.

Peachtree Park Apartments resident Andrea Palese begins to clean up

Erik Lesser/EPA-EFE Peachtree Park Apartments resident Andrea Palese begins to clean up — Peachtree Park Apartments resident Andrea Palese begins to clean up

A home in Pinellas County, close to Tampa in Florida, was badly hit by the storm

Tampa Bay Times/ZUMA Press Wire/REX/Shutterstock A home at Harbor Lights Club mobile home park in Pinellas County in the aftermath of Hurricane Helene — A home in Pinellas County, close to Tampa in Florida, was badly hit by the storm

Power lines and fallen trees lay on the ground in Crawfordville, Florida

Marco Bello/Reuters Power lines and fallen trees lay on the ground in Crawfordville, Florida — Power lines and fallen trees lay on the ground in Crawfordville, Florida

As the flood water receded along the west coast of Florida, it left behind damaged or destroyed buildings.

Cristóbal Herrera/EPA-EFE A destroyed building in Cedar Key, Florida

Cristóbal Herrera/EPA-EFE View of damage left behind by Hurricane Helene in Cedar Key, Florida,

EPA View of damages left behind by Hurricane Helene in Keaton Beach, Florida.

An oak tree fell on a home in Anderson, South Carolina.

Ken Ruinard/The Anderson Independent Mail/USA TODAY NETWORK via REUTERS A large oak lies on a home in Anderson, South Carolina

Emergency teams, like these Marine deputies, were on hand to rescue those who required assistance.

Below an airboat transports residents rescued from flood waters due to storm surge in Crystal River.

Luis Santana/Tampa Bay Times/ZUMA Press Wire/REX/Shutterstock An airboat transports residents rescued from flood waters due to storm surge in Crystal River

Off the coast of Florida, a man and his dog were rescued by the US Coast Guard, while in St Petersburg a capsized boat washed ashore.

US Coast Guard/Handout via REUTERS A US Coast Guard Air Station crew rescues a man and his dog during Hurricane Helene after his sailboat became disabled and started taking in water off Sanibel Island, Florida

Joe Raedle/Getty Images A capsized boat washes ashore in Saint Petersburg, Florida

Even before its arrival, the storm had caused power outages for more than one million people and severe flooding in several areas.

Trucks belonging to Duke Energy were pictured in line waiting to repair damage once the storm had passed.

Stephen M. Dowell/Orlando Sentinel/Tribune News Service via Getty Images Charles Starling, a lineman with Team Fishel, is pelted with rain as he walks by a row of electrical line trucks staged in a field in The Villages, Florida

Ahead of the Hurricane many residents moved to shelters like this one at a school in Tallahassee.

Octavio Jones/Reuters Amber Hardin, 27, spends time with her dog Ducky while taking shelter from Hurricane Helene at Leon High School near downtown Tallahassee, Florida

Kathleen Flynn/Reuters Lindsay Smith, her four-month-old son Maze Crawford, and mother Dieonne Smith, wait for the arrival of Hurricane Helene at Lincoln High School, which was opened as a shelter in Tallahassee, Florida

President Joe Biden and state authorities had urged people to heed official evacuation warnings before Helene hit, though some chose to stay in their homes to wait out the storm.

People boarded up windows and prepared their properties as best they could.