Hurricane Ivan back up to Category 5
Storm is predicted to hit western Cuba on Monday
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 Cubans evacuate as Ivan approaches.
 The Jamaican government is surveying the damage from Ivan.
 Floridians preparing for the worst.
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• Florida Keys cautiously optimistic
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| HURRICANE IVAN | As of 11 p.m. Sunday ET
Position of center: 175 miles southeast of the western tip of Cuba
Latitude: 19.7 north
Longitude: 83.2 west
Top sustained winds: Near 160 mph
Source: Natl. Hurricane Center
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MIAMI, Florida (CNN) -- Hurricane Ivan, blamed for at least 42 deaths in the Caribbean, pounded the Cayman Islands on Sunday and regained strength as it headed toward the western tip of Cuba.
Communications with Grand Cayman were hampered by widespread power outages, but horizontal rain and flooding so bad that people had fled to their rooftops were reported. (Full story)
"Reports from ham radio operators and the Cayman Meteorological Service indicate that power is out throughout the island," said the National Hurricane Center in Miami.
"Numerous buildings have lost their roofs. Water up to two feet deep covers the airport runway, and water as high as five feet is flowing through many homes."
With low-lying areas evacuated, many of the Cayman Islands' 45,000 residents hunkered down in shelters built to withstand strong hurricanes.
All but a few tourists left the island ahead of the storm, government spokeswoman Patricia Ebanks said.
All 100 residents of the smallest of the Caymans -- Little Cayman -- flew to Grand Cayman, 90 miles away.
Many of the 2,000 residents of Cayman Brac -- the second-smallest island -- were also in shelters on Grand Cayman, Ebanks said. Yet after the evacuations, the storm's path shifted westward, veering away from the smaller islands and more directly toward Grand Cayman.
Weakened to a Category 4 hurricane after passing Jamaica, Ivan regained strength and by Sunday evening was again a Category 5 storm, with maximum sustained winds near 160 mph (260 kph).
At 11 p.m. ET, Ivan was moving west-northwest near 9 mph (15 kph), according to the center. Its eye was about 175 miles (285 kilometers) southeast of the western tip of Cuba.
Hurricane-force winds extended up to 90 miles (150 kilometers) from the eye, and winds of tropical storm strength extended as far as 200 miles (325 kilometers), the center said.
The hurricane center has shifted its projections of the storm's path to the westward over the past two days as Ivan failed to turn northeast, reducing the odds it would follow the paths of Charley and Frances in south and central Florida over the past month.
The latest forecast put the storm farther west of Havana, Cuba, and well clear of south Florida and the Keys.
A chart of the storm's most likely path showed it passing over the western end of Cuba on Monday, heading into the Gulf of Mexico and hitting the northwest Florida Panhandle midday Wednesday, the hurricane center said.
Mexico issued a hurricane watch and a tropical storm warning for the northeastern Yucatan Peninsula from Tulum to Progreso, including Cozumel.
Florida Gov. Jeb Bush ordered the Florida Keys evacuated days ago, when forecasters were predicting the storm was headed in that direction.
Many of the people who live in the Keys have left, driving on U.S. 1 -- the only highway leading out of the island chain, Bush said.
A tropical storm watch was in effect for the Florida Keys from the Seven-Mile Bridge westward to the Dry Tortugas, the center said.
Ivan has been blamed for at least 42 deaths as it passed east to west through the Caribbean during the past week: 17 in Jamaica, 17 in Grenada, four in Venezuela and four in the Dominican Republic, according to officials from those countries.
Eight people -- including at least three children -- drowned in the southern Jamaica town of Portland Cottage about 40 miles (65 kilometers) from Kingston when a tidal surge pushed a wall of water into their coastal neighborhood, according to Jamaica's Office of Disaster Preparedness.
Rebecca Edwards, whose daughters Tiffany, 3, and Lisanne, 2, were among the dead, said the water was up to her chest when the wave hit.
Nine people died in other areas on the southern side of the island, disaster officials said. Most of the dead either drowned or were killed by falling trees. One woman died of complications from childbirth when she was unable to reach a hospital, the disaster office said.
Cubans expressed anxiety about the potential destruction predicted to hit their island Monday afternoon or evening.
A hurricane warning was in effect for Cuba from Pinar del Rio to Ciego de Avila, including the Isle of Youth. A hurricane watch remained in effect for the rest of Cuba.
Cuban President Fidel Castro went on television Saturday to warn residents to stock up on supplies and board up their homes.
"Whatever the hurricane does, we will all work together," he said.
Castro was quick to turn down any offer of relief that might come from the United States.
"From beforehand, I am saying we will not accept any help from those who have applied economic measures against our country," he said. "Save the hypocrisy of offering aid to Cuba."
Even with storm's center predicted to pass west of Havana, the Cuban capital was still in danger's way.
Many of Havana's 2.5 million residents live in dilapidated housing that has been poorly maintained for the past 45 years.
The government ordered everyone living above the fourth floor of any building to move to a lower level. Old and fragile buildings in Cuba have collapsed during thunderstorms.
Cubans usually take warnings to seek safer shelter seriously.
Without hardware stores in each community, Cubans are unable to board up their windows with plywood. Even tape is hard to find.
CNN's Karl Penhaul in Kingston and Lucia Newman in Havana contributed to this report.
