Ten children -- including a pair of infants four and seven months old -- perished in Monday's fierce twister that steamrolled entire neighbourhoods and two schools in the Oklahoma City suburb of Moore.
"Our hearts go out to all the people affected by this tragedy," Amy Elliott of the state medical examiner's office said in an email detailing the revised breakdown of the official death toll. Previously, authorities had put the number of child fatalities at nine.
The preliminary causes of death for the two dozen casualties included blunt force traumas, as well as asphyxiation, according to the office, which also released some of their names. Both babies died of head trauma.
Some 237 people were injured by the hurricane-strength storm, Andy Oden, a spokesman for the Oklahoma Department of Emergency Management, told AFP.
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It was not immediately clear if anyone remains unaccounted for, with Governor Mary Fallin urging everyone affected to come forward.
Homeland Security Secretary Janet Napolitano, on a visit to the area today, pledged government support for those struggling to piece their lives back together.
"At some point the cameras will leave, the national ones will leave first, then the local ones," she said. "But on behalf of President Obama and on behalf of (the Federal Emergency Management Agency), we will be here to stay until this recovery is complete."
For residents whose lives were turned upside down, relief about having survived turned to heartbreak as the extent of the disaster slowly sunk in.
"It was my home, my kids' home," said the 38-year-old father of two, both of whom escaped harm. Carver was not allowed past because his house was in an area still deemed too dangerous.
"Now it's gone. There's nothing left. It's a pile of sticks.... And they're keeping me away," he said.