The death toll in eastern Kentucky has risen to at least 16 as flooding unleashed by torrential rainfall.
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Police and National Guard troops, including personnel from neighbouring states, used helicopters and boats to rescue dozens of people from homes and vehicles in Kentucky's Appalachian coal-mining region. Video from local media showed floodwaters reaching the roofs of houses and turning roads into rivers.
"This isn't over. While we're doing search and rescue, there are still real dangers out there," Governor Andy Beshear told a morning news conference.
After a helicopter flyover of the hardest-hit areas with Deanne Criswell, head of the US Federal Emergency Management Agency, Beshear said he was stunned by the scope of the flooding.
Most of Jackson, a town of 2,200 people about 160km southeast of Frankfort, the state capital, was submerged, he said.
"Hundreds of homes, their ballfields, their parks, businesses, under more water than I think any of us have ever seen in that area," he told reporters. "Just devastating."
Mr Beshear said the number of confirmed flood-related fatalities yesterday rose to 16 from 15, including at least six children, and that the death toll would almost certainly climb as floodwaters recede and search teams find more bodies.
"There's still a lot of people unaccounted for," he said, declining to quantify the number missing. "We may be updating the count of how many we lost for the next several weeks."
The floods resulted from downpours of 13 to 25cm of rain that fell over the region in 24 hours, a deluge that may prove unprecedented in the region's record books, said William Haneberg, an environmental sciences professor and director of the Kentucky Geological Survey.
An upper level high pressure system is expected to continue aiding well above average and potentially dangerous temperatures throughout the West into the first full weekend of September.