Authorities in southern Japan on Wednesday linked at least 11 more fatalities to powerful earthquakes last week that killed 48 people.
The "disaster-related deaths" were caused mainly by illnesses exacerbated by difficult living conditions for evacuees following the two biggest quakes, according to the prefecture of Kumamoto.
More than 100,000 people are staying at schools, gymnasiums and community centres in Kumamoto and Oita prefectures. Some have also stayed in cars because shelters were crowded, or because they were concerned about aftershocks.
The death of a 51-year-old woman from deep vein thrombosis earlier in the week prompted Prime Minister Shinzo Abe late Tuesday to call for "urgent attention" to prevent such cases.
"We need to promptly prepare the residential setting so as to fundamentally resolve problems stemming from the inconvenient life at shelters, including economy-class syndrome [deep vein thrombosis]," Abe said.
The Meteorological Agency said that more than 690 aftershocks had rattled the island of Kyushu since a magnitude-6.5 quake struck Kumamoto on Thursday evening, followed by a second quake with a magnitude of 7.3 early Saturday.
One body was recovered Wednesday, raising the official death toll to 48. Three people are still missing, broadcast NHK reported.