At least 19 people were killed, and 20 injured when a knife-wielding man went on a rampage early Tuesday at a facility for the disabled in the Japanese city of Sagmihara.
The Sagamihara City fire department told the Associated Press that 19 people are confirmed dead in the attack.
The fire department said a doctor or doctor on the scene confirmed the deaths around 8 a.m. local time.
Police told Japanese broadcaster NHK they received a call from an employee of the facility, located west of Tokyo, just after 2:30 a.m. on Tuesday, who said a man carrying a knife broke into the building.
The man later turned himself in at a police station.
NHK said the suspect, 26, is a former employee at the facility, Tsukui Yamayuri-en, on suspicion of attempted murder. Another broadcaster, NTV, said he broke into the facility by smashing a window with a hammer, and that he was upset because he had been fired, but that could not be independently confirmed.
Asahi Shimbun newspaper reported that the suspect was quoted by police as saying "I want to get rid of the disabled from this world."
The facility has about 150 long-term residents with learning difficulties and physical disabilities, NHK reported, with some residents as young as 18, and others as old as 75.
Television footage showed a number of ambulances parked outside the facility, with medics and other rescue workers running in and out.
Mass killing are relatively rare in Japan, which has extremely strict gun-control laws. In 2008, seven people were killed by a man who slammed a truck into a crowd of people in central Tokyo's Akihabara electronics district and then stabbed passers-by.
Fourteen were injured in 2010 by an unemployed man who stabbed and beat up passengers on two public buses outside a Japanese train station in Ibaraki Prefecture, about 25 miles northeast of Tokyo.
The Associated Press contributed to this report.