TOKYO — Pham Tran, a 43-year-old Vietnamese who runs a buying and selling firm in Osaka, was busy responding to inquiries from her clients in Vietnam after the health issue of “red yeast rice” dietary supplements surfaced in Japan final month.

Five individuals who took the dietary supplements, produced by Osaka-based Kobayashi Pharmaceutical, have died. Japan’s Ministry of Health, Labor and Welfare stated Monday a complete of 231 individuals had been hospitalized as of Sunday.