TOKYO — Pham Tran, a 43-year-old Vietnamese who runs a trading company in Osaka, was busy responding to inquiries from her customers in Vietnam after the health issue of “red yeast rice” dietary supplements surfaced in Japan last month.

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

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