The International Red Cross estimates that about 4.2 million people were affected by the back-to-back Category 4 hurricanes in November in Honduras, Nicaragua and Guatemala.
Central American authorities have confirmed more than 30 deaths with the majority of the victims in Nicaragua. The US National Hurricane Center has warned of "life-threatening flash flooding" due to heavy rainfall from Iota's tail.
Along with heavy winds and rain, Iota will raise sea levels by as much as 6 metres above normal tides. It is expected to quickly weaken inland, but will dump as much as 76 cm of rain over the next few days.
Families waded through the flooded streets of the northern Honduran city of San Pedro Sula, while cars sat almost submerged in parts of the central Guatemalan city of San Pedro Carcha, television footage and images posted on social media showed.
The Nicaraguan government reports no immediate fatalities, but authorities in Honduras say a child died in a collapsed house, as Eta unleashes fierce winds, tearing up trees and ripping roofs off homes.
Eta is expected to strengthen to Category 5 and forecasters warn of massive flooding and landslides across a vulnerable region.
Forecasters expect Eta to become a hurricane and is predicted to be nearing the Nicaraguan coast early Tuesday.
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