More than 2,000 people have been moved to shelters in Jamaica as Hurricane Matthew heads toward the island.
The country's government says it is on "high alert" and has held an emergency meeting to prepare for the storm's arrival.
The hurricane is currently off the northern coast of Colombia and Venezuela but is forecast to move northwest, say monitors in the US.
Its winds are gusting up to 155mph (250kph), making it one of the most powerful in recent years.
It was previously a category 5 storm - the most powerful - but it has since weakened slightly, according to the National Hurricane Center (NHC).
Hurricane Matthew is one of the strongest storms to threaten the Caribbean since Hurricane Felix in 2007, which killed 150 people and caused $720m of damage.
The most recent category 4 storm to hit the region was Hurricane Joaquin last year.
That struck the Bahamas, Bermuda, the Antilles and the Turks and Caicos and caused $120m of damage and killed 34.
If Matthew does strike Jamaica, it could be the worst to hit the island since Wilma, which hit as a tropical depression in 2005, causing $93m in damage.
The NHC currently predicts that Matthew will tear across Jamaica before hitting the southern coast of Cuba late Monday or early Tuesday.
Forecasters said that up to 15 inches (38cm) of rain could fall in Jamaica and southern Haiti but the NHC said isolated areas could receive up to 25 inches (63cm).
Jamaicans have already begun stocking up on supplies of water and other food in case of a disaster, emptying store shelves.
Local Government Minister Desmond McKenzie told The Star newspaper that authorities had been instructed to "go full speed ahead" with efforts to prepare.
The US said its embassy in Jamaica would be closed on Monday and Tuesday for consular services "due to the anticipated effects of Hurricane Matthew".
In Haiti, authorities warned residents living on the islands in the south of the country that they were "first at risk," and urged them to prepare.
Edgar Celestin, a spokesman for the Haitian civil protection agency, said: "We invite them to secure the area surrounding their homes and begin to stock up on water and food."
The Dominican Republic has also been put on alert and Colombia issued a high-level alert for much of its northern coast, warning of "extremely dangerous life-threatening conditions" and of giant waves up to five meters high.
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