A former employee killed 19 people at a home for the mentally disabled early Tuesday morning in Sagamihara, a city 50 kilometers (30 miles) west of Tokyo. Mass killings are relatively rare in Japan, but they have happened before:

March 20, 1995: Doomsday cult Aum Shinrikyo disperses sarin nerve gas on Tokyo subway trains, killing 13.

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June 8, 2001: A man kills eight children and injures 13 others and two teachers in a knife attack at an elementary school in the city of Osaka. The incident shocks Japan and leads to increased security at schools.

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June 8, 2008: Seven people are killed by a man who slams a truck into a crowd in central Tokyo's Akihabara electronics district and then get out and starts stabbing people.

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July 26, 2016: Nineteen people have been confirmed dead in the knife attack on a home for the disabled outside Tokyo. It is the deadliest mass killing in Japan in decades.