PENSACOLA, N.C. (AP) Rescue crews and volunteers facing obstacles at every turn in North Carolinas remote mountains paddled canoes across swollen rivers and steered horses past mudslides in the rush to reach those stranded or missing by Hurricane Helenes rampage that killed more than 200 throughout the Southeast.

Now a week since the storm first roared onto Floridas Gulf Coast , the search continued for people who have yet to be heard from in places where phone service and electricity were knocked out. Pleas for help came from people running low on medicine or in need of fuel for their generators.

How many people are missing or unaccounted for isnt clear. The death toll soared to 215 people on Thursday as more victims were found, making Helene the deadliest hurricane to hit the mainland U.S. since Katrina in 2005. Roughly half the victims were in North Carolina, while dozens more were killed in South Carolina and Georgia.

Each road presents a new challenge for rescuers

Along the Cane River in western North Carolinas Blue Ridge mountains , rescuers from the Pensacola Volunteer Fire Department were cutting their way through trees at the top of a valley nearly a week after a wall of chocolate-milk colored water swept through for hours.

Pensacola, which sits a few miles from Mount Mitchell, the highest point east of the Mississippi River, lost an untold number of people, said Mark Harrison, chief medical officer for the department.

Were starting to do recovery, he said Thursday. Weve got the most critical people out.

Harrison was helping dispatch volunteers driving all-terrain vehicles on supply runs to people still on ridgetops. Many dont want to leave their houses, while others lost their vehicles and need help getting to town.

Bradley Billheimer, who hiked down to the fire station to access the internet, said he just talked to his mom for the first time since the storm. He feared his house will be without power for months.

I think were going to walk out in a couple of days, he said.

In another county that sits alongside the Tennessee state line, crews were just finishing clearing main routes and reaching side roads that wind through switchbacks and cross small bridges that can be tricky to navigate even in the best weather. Each road presented a new challenge.

Everything is fine and then they come around a bend and the road is gone and its one big gully or the bridge is gone. said Charlie Wallin, a commissioner in Watauga County. We can only get so far.

Most people the crews come across turn out to be fine and just in need of water, but every day there are new requests to check on someone who hasnt been heard from yet, Wallin said. When the search will end is hard to tell, he said.

You hope youre getting closer, but its still hard to know, he said.

A week into the search and rescue operations in Buncombe County, which includes the hard-hit tourist city of Asheville and where more than 72 have been killed, the county doesnt have an official tally of people who are unaccounted for or missing.

The county sheriff said his office believes more than 200 people are missing, although other officials said the number is constantly changing when crews make contact with people who hadnt been accounted for or receive new names of people who may be missing.

Were continuing to find people. We know we have pockets of people who are isolated due to landslides and bridges out, said Avril Pinder, the county manager. So they are disconnected but not missing.

Frank Johnson, who owns a company that makes robotic cutting machines in Mars Hill, North Carolina, said he feels like he is running a relief mission on his own. Hes using his own workers, volunteers and supplies and know-how from his company to get water, food, fuel and other supplies to his neighbors.

Ive been hearing there are entire neighborhoods gone. Im still not sure people have the whole grasp of what were dealing with, Johnson said.

Electricity is being slowly restored, as the number of homes and businesses without power dipped below 1 million for the first time since last weekend, according to poweroutage.us . Most of the outages are in the Carolinas and Georgia, where Helene struck after coming into Florida on Sept. 26 as a Category 4 hurricane.