As the winds whipped up by Severe Tropical Cyclone Yasi began wreaking havoc along Queensland coast, state Premier Anna Bligh warned the region's one million residents it was too late to escape "the most catastrophic storm to ever hit our coast."

Yasi, the worst storm in a century, was expected to slam into the coast around midnight Wednesday (1400 GMT), the Bureau of Meteorology said, after it was upgraded early in the day to a category five storm from category four.

"This impact is likely to be more life-threatening than any experienced during recent generations," it said in an ominous warning ahead of the first category five storm to hit the area since 1918.

Wild advance winds tore the roof off a building near where 500 people were taking shelter in Innisfail, which lies directly in Yasi's path, Mayor Bill Shannon said.

"The eye is five hours away and it's already causing damage so it's pretty worrying," he told the AAP news agency as Yasi churned 175 kilometres northeast of the town.

Power lines and trees were felled along the coast by early gusts, with an offshore weather station clocking 185 kilometres an hour winds before it was destroyed.

Yasi, which measures up to 800 kilometres (500 miles) across, was on course to hit the area between Innisfail, south of the tourist hub of Cairns, and Cardwell, 100 kilometres south of Innisfail.

Prime Minister Julia Gillard said Yasi looked like the worst cyclone in Australian history and said the nation was with Queenslanders as they faced "many, many dreadful, frightening hours" waiting for it to strike.

"This is probably the worst cyclone that our nation has ever seen. In the hours of destruction that are coming to them, all of Australia is going to be thinking of them," she said.

Yasi was expected to generate highly destructive winds of up to 295 kilometres per hour, up to 700 millimetres (27.5 inches) of rain and storm surges that are threatening to flood towns and tourist resorts.

The storm is so enormous that it would almost cover the United States or large parts of Europe, News Ltd newspapers reported.

Locals further from the seafront who did not evacuate were told to batten down and prepare a "safe room", like a bathroom or a basement, with mattresses, pillows, a radio, food and water supplies to wait out the cyclone.

Thousands of people have already fled the area and seaside residents were urged to desert their homes ahead of a dangerous storm surge of between 2.3 and seven metres (eight to 23 feet) that was likely to cause major flooding.

Two hospitals in Cairns were evacuated and shuttered, their patients were airlifted on military planes to the city of Brisbane.

Airports and ports in Cairns and other cities along the coast were shut to traffic Wednesday as winds gathered strength.

The streets of Cairns, usually bustling with holidaymakers and diving enthusiasts, were eerily deserted.

More than 10,000 people were sheltering in 20 evacuation centres across the region -- some so packed that people were turned away -- while tens of thousands more were staying with family and friends.

Anticipating a massive relief operation, the military was readying supply ships with aircraft landing capability to help with search and rescue once the storm passed.

"We're just hoping and praying we can all get through the night," said Ross Sorbello, from the endangered town of Tully as residents looked down the barrel of approaching Yasi.

The storm's size and power dwarfs Cyclone Tracy, which hit the northern Australian city of Darwin in 1974, killing 71 people and flattening more than 90 percent of its houses.

It is also twice the size and far stronger than the category four Cyclone Larry that caused Aus$1.5 billion ($1.5 billion) of damage after hitting agricultural areas around Innisfail, just south of Cairns, in 2006.

Forecasters said Yasi could be "horrific" and take 24 hours to weaken after it makes landfall.

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