Missouri tornado is the latest extreme weather after storms batter states in the midwestern and southern United States over the last week.

The storm touched down in Bollinger County in the early morning hours on Wednesday, “I can confirm five fatalities,” Sheriff Casey Graham posted on social media.

He said search and rescue was continuing following “a significant tornado” that left downed trees and destroyed homes in its path.

“The damage is pretty widespread,” Sergeant Clark Parrott with the Missouri State Highway Patrol told reporters. “It’s just heartbreaking to see it.”

Large areas of the midwestern and southern US are bracing for more storms that could bring additional twisters and hail storms. During the last several months, many regions of the US have grappled with challenges posed by extreme weather and an unending parade of winter storms.

Last week, strong storms generated 11 tornadoes that caused widespread destruction across numerous midwestern and southern states, killing at least 32 people.

In Missouri, emergency workers and first responders were conducting searches and attempting to clear debris in order to reach homes.

“It’s going to be a slow process, but for now, it’s an active search and rescue,” Parrott said.

The tornado touched down at 3:30am (08:00 GMT) in a rural area of Bollinger County, about 80 kilometres (50 miles) south of the city of St Louis. Reuters reported that photographs on social media show extensive damage to homes in the city of Glen Allen, about 177 kilometres (110 miles) south of St Louis.

Justin Gibbs, a meteorologist with the National Weather Service (NWS) based in Kentucky, told The Associated Press that the tornado travelled between 24 and 32 kilometres (15 to 20 miles) and remained on the ground for about 15 minutes.

The fact that it took place in the early morning may have exacerbated the human toll.

“It’s definitely a nightmare from a warning standpoint,” Gibbs said. “It’s bad anytime, but it’s especially bad at 3:30 in the morning.”