A rescue operation is under way in Central America and southern Mexico, where death toll from a tropical storm reached at least 120 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.
President Vicente Fox has told the emergency services to concentrate on saving lives, reports Reuters.
According to the AP, President Уscar Berger of Guatemala called on Congress to declare a state of emergency, to allow the government to require evacuations of dangerous areas, set prices on emergency supplies and provide federal coordination of relief efforts.
"But we're only going to do all of this if it is absolutely necessary," Mr. Berger said.
In San Salvador, the capital of El Salvador, at least 49 people were killed in four days of mudslides and flooding. Nationwide, more than 16,700 Salvadorans had fled their homes for 167 shelters.
Among those evacuated were residents of Santa Tecla, outside San Salvador, where an earthquake caused a landslide in January 2001. Officials have expressed concern that heavy rain or another quake would cause another landslide.
In Nicaragua, nine people died, including six migrants believed to be Ecuadoreans killed in a boat wreck attributed to the storm. Four deaths were reported in Honduras and one in Costa Rica.
In Tapachula in Mexico's Chiapas region, near the border with Guatemala, two people died when a river overflowed and roared through the city, sweeping them away and carrying wooden and metal houses with it, the authorities said Wednesday. The flooding forced hundreds of evacuations.