Water-damaged items sit outside a house in Squabble Creek, near Buckhorn, in Eastern Kentucky. AFP
Some areas in the mountainous region are still inaccessible following the flooding in the state's east that turned roads into rivers, washed out bridges and swept away houses. Off-and-on rain plus poor cell phone service are also complicating rescue efforts.
"This is one of the most devastating, deadly floods that we have seen in our history... And at a time that we're trying to dig out, it's raining," Governor Andy Beshear told NBC's "Meet the Press."
"We're going to work to go door to door, work to find, again, as many people as we can. We're even going to work through the rain. But the weather is complicating it."
A Perry County school bus, along with other debris, sits in a creek near Jackson, Kentucky, on Sunday. AFP
The number of dead in the flooding, caused by torrential rain that began on Wednesday, is expected to rise even further.
"We're going to be finding bodies for weeks, many of them swept hundreds of yards, maybe a quarter mile-plus from where they were lost," Beshear said on "Meet the Press."
The governor toured flooded areas and made stops in three counties on Sunday. Across the rain-soaked portions of the state, more than 350 people are living temporarily in shelters, he said.
In the town of Jackson, the seat of hard-hit Breathitt County, state, local and federal rescue teams and aid workers fanned out.
Some were distributing water bottles to those in need. A boat marked "FEMA Rescue 4" sat on a trailer, indicating the presence of federal emergency crews.
Volunteers work at a distribution center of donated goods in Buckhorn, Kentucky, on Sunday. AFP
Receding floodwaters had left a thick coating of dust on the streets as dark clouds presaged more rain ahead.
Some 35 miles (55 kilometres) south in the tiny community of Buckhorn, volunteers at a distribution center told the media that 700 to 800 people had come through on Sunday alone to collect donated supplies ranging from food to paper towels and toiletries.
The floods hit a region of Kentucky that was already suffering from grinding poverty â€” driven by the decline of the coal industry that was the heart of its economy â€” taking everything from people who could least afford it.
"It wiped out areas where people didn't have that much to begin with," Beshear said.