A knife-wielding attacker killed a 12-year-old schoolgirl and a man before stabbing himself to death in a rampage outside Tokyo on Tuesday.
Authorities say more than a dozen, including several children, were injured in the mayhem.
The mass stabbing in the town of Kawasaki, south of the Japanese capital, was a rare attack in a country with one of the lowest rates of violent crime in the developed world, and there was no immediate detail on the suspect’s motive.
Kiyoshi Matsuda, deputy director of the Nippon Medical School Musashi Kosugi Hospital, told reporters that the 12-year-old schoolgirl and a 39-year-old man had succumbed to their injuries.
Local media reported that the suspected attacker, a man in his 50s, had also died of his wounds after turning the knife on himself. Emergency services said at least 16 others had been injured in the attack.
“It is a very harrowing case. I feel strong anger,” Japan’s Prime Minister Shinzo Abe said in televised remarks.
“I offer my heartfelt condolences to the victims and hope the injured recover quickly.”
The bloodshed came as Donald Trump wrapped up a state visit to Japan, and the US president offered his “prayers and sympathy” to the victims as he met troops outside Tokyo.
Standing aboard a Japanese military ship, he said that “all Americans stand with the people of Japan and grieve for the victims and for their families”.