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Nebraska was pummeled by a round of dangerous severe weather Monday with one fatality reported and the governor’s office saying at least four towns had been hit hard.

Damage was reported in Pilger, Wisner, Stanton and Pender, all in northeast Nebraska. The city of Pilger was closed to all but emergency personnel, according to the state’s emergency management agency.

Sightings of a rare “double tornado” are also being reported, according to CNN meteorologist Chad Meyers.

Sanford Goshorn, the Stanton County, Nebraska, emergency manager, told CNN he couldn’t confirm numbers of people injured after tornado-like winds hit the rural Nebraska county saying, “We’re still digging people out.”

At least one person was killed in weather-related incidents a spokeswoman for Faith Regional Health Services in Norfolk, Nebraska, told CNN. There were 15 patients at the hospital as of Monday evening, and “many more” are expected, spokeswoman Jacque Genovese said.

The National Weather Service also issued a tornado emergency warning for the town of Burwell, located in Garfield County, where a confirmed “large, violent and extremely dangerous tornado” was sighted. The storm included hail and residents in its path were urged to take immediate cover.

Damage from the storm also reached the area of Sioux Falls, which borders neighboring Iowa.

“We’ve had reports of brief touchdowns as the storms near Sioux City, Iowa,” said Todd Heitkamp, Warning Coordination Meteorologist, National Weather Service Sioux Falls. “We’ve had widespread wind and flooding damage due to the series of storms that have been ongoing today. We’ve had reports of up to 4 inches of rain within an hour in the tri-state area (South Dakota, Minnesota, Iowa). The main thing is widespread tree damage.”