A rescue operation is under way in Central America and southern Mexico, where mudslides caused by a tropical storm have killed at least 160 people.
The emergency services are continuing to find buried bodies as they reach more isolated villages.
Although Tropical Storm Stan has passed, heavy rain is still falling and river levels are dangerously high.
The worst affected countries, El Salvador and Guatemala, are struggling to evacuate everyone at risk.
Shelters in both countries are holding thousands of people, while road links have been cut off.
"The emergency is bigger than the rescue capacity, we have floods everywhere, bridges about to collapse, landslides and dozens of roads blocked by mudslides," a spokesman for the Salvadoran Red Cross said.
In Mexico, reports are now coming in that dozens of people are missing.
Across the region, mountain villages and urban shanty towns were ill-defended against the tide of water and mud.
Alexander Flores said his home on the edge of San Salvador was buried under 6ft (2 metres) of dirt and rocks.
"I just heard two shouts from my mother, saying 'Alex, Alex', maybe for me to help her or her trying to save me," he told Reuters.
His mother and five of his siblings - including a new-born baby - died, he said.
Thousands of Salvadorans have fled their homes to seek shelter, not just from Stan but also from the Ilamatepec volcano, which killed two people when it erupted on Saturday.
Authorities warned of another possible eruption on Wednesday and widened the exclusion zone around the volcano from 4km to 5km (about three miles).
Stan briefly reached Category One hurricane strength, slamming into Mexico on Tuesday with winds of 130km/h (80mph), before fading quickly.
However, heavy rains have fallen solidly over some areas for four days.
"The river is huge, people have lost their things. It rained all night and it's still raining," said coffee salesman Lucas Lopez in Tapachula, in Mexico's Chiapas state.
The death toll so far has been put at 79 in Guatemala and 62 in El Salvador. At least 19 deaths have been reported across Mexico, Nicaragua, Honduras and Costa Rica.
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