The deaths of at least 11 Americans over the past year have made travelers anxious and led some to simply stay away. Headlines that characterize the illnesses and deaths as suspicious have painted the Caribbean island nation — where tourism is the leading industry — as a place where something nefarious might be lurking amid the pools, beaches and palm trees.

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The issue led the country’s tourism minister to blast media coverage in a Friday news conference, downplaying reports of “an avalanche of death” as sensational portrayals and reading aloud autopsy reports of several prominent cases.

“It’s not true these deaths were mysterious. Science also exists here in the Dominican Republic,” Francisco Javier García said. “We have determined the cause of death of all the deaths that have happened here. There are no mysterious deaths here in the Dominican Republic.”

At this point, there’s no evidence that the spate of death and illness in the Dominican Republic this year is out of the ordinary for any popular tourist destination, according to the U.S. State Department, which said it has seen no unusual spike in deaths reported from the country.

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The official cause of death of Miranda Schaup-Werner, a 41-year-old psychotherapist from Pennsylvania who died at a hotel in May, was “heart attack, pulmonary edema and respiratory insufficiency,” García said. Pulmonary edema is a condition of fluid in the lungs.

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In the case of Nathaniel Edwards Holmes and Cynthia Ann Day, the Maryland couple found dead in their room at the Bahía Príncipe hotel, the autopsy results showed as cause of death “pulmonary edema and respiratory insufficiency.”

Toxicology results for the deaths of the three tourists were not yet available and are expected within 30 to 40 days, he said.

About 2.7 million Americans visited the Dominican Republic last year, according to the State Department, which publicly releases data only about unnatural deaths, such as car crashes and drownings. It does not release information about deaths by natural causes, such as heart attacks or strokes, even though it compiles reports on all Americans who die abroad.

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It is a matter of statistics that a certain number of travelers will suffer serious illnesses, accidents and even death while traveling internationally. The death rate in the Dominican Republic is not any higher than the death rate in the States, officials said.

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The FBI is investigating the deaths of Schaup-Werner, Holmes and Day. Officials describing Schaup-Werner’s death have given conflicting statements to media outlets.

A family spokesman said Schaup-Werner became ill after drinking from her room’s minibar, which touched off a round of unverified speculation about whether tainted alcohol is to blame for the cluster of deaths. An attorney for the family says his team is conducting its own investigation.

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The New York Post even sent a reporter to one of the resorts to smell some of the alcohol, and noted that “the vodka had a strange, potent smell resembling pure alcohol.”

Bad booze would not be unheard of. It could be part of the reason stories of death and sickness in the Caribbean have gained so much attention.

In 2017, a Milwaukee Journal Sentinel investigation found dozens of tourists that fell violently ill — often blacking out — after drinking alcohol at popular all-inclusive resorts in Mexico. Weeks after that investigation was published, the State Department updated its safety advice for traveling to Mexico, suggesting tourists drink in moderation and seek medical attention immediately if they feel ill.

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Phil Sylvester, a travel safety expert and a spokesman for World Nomads, a global travel insurance company based in Australia, said his company also noted several issues from Australian travelers in Bali a few years back that he thinks were connected to toxic homemade alcohol.

The barrage of bad news has caused frustration and concern in the Dominican Republic, where tourism accounts for about 22 percent of the economy, directly and indirectly.

The stories have coincided with other damaging reports. Famed Boston Red Sox slugger David Ortiz was shot in the back at a restaurant in Santo Domingo, the country’s capital, last week. A 51-year-old woman from Delaware, Tammy Lawrence-Daley, has recently spoken about a vicious assault she says she suffered at a resort in Punta Cana in January.

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“We can see that many international media outlets are just going for it as news, just to get the headline, and they are not really getting into what’s going on . . . The caricatures have been made, and some in media have done a lot of damage,” Luis José Chávez, president of the Dominican Tourism Press Association, told The Washington Post. “The whole country is trying to get over this and gain back the image of what we really are.”

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The Dominican Republic, just a few hours on a plane from many areas in the southern and eastern United States, might be a victim of its own success as an increasingly popular vacation destination for Americans, and one that attracts a crop of travelers not used to venturing to countries with different medical and legal systems.

The reports led Rep. Frank Pallone Jr. (D-N.J.) to ask the State Department to reassess the Dominican Republic’s travel safety. They have also led to a flood of complaints from people who say they, too, have fallen ill while traveling in the Dominican Republic.

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More than 600 online visitors to the website IWasPoisoned.com in the past few months posted symptoms including nausea, vomiting and diarrhea that they said they experienced in the Dominican Republic. It is an unusually high volume for the website, which displays anonymous accounts of food poisoning, including at restaurants in the United States, founder Patrick Quade said.

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The spike in posts on Quade’s site came after news of the deaths of Holmes and Day, the Maryland couple, he told The Post.

It can’t be ruled out that the increase in food poisoning reports could be an effect of more media attention on Punta Cana and its resorts.

Travel insurance operators told The Post that they have been inundated with inquiries about how their coverage, which applies to misfortunes such as illness and injury, might work for those headed to the Dominican Republic.

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Insurers know the cold statistical truth that lurks in the reams of travel data they amass. Even for vacations to tropical paradises such as the Dominican Republic, a small subset of trips will be marred by serious health issues and other tragedies.

“Ninety percent of the time, your holiday goes off without a hitch,” Sylvester, of World Nomads, told The Post, adding that of the other 10 percent of trips in which claims are filed, the vast majority involve things such as a lost cellphone, a pair of sunglasses that flew overboard or minor health issue such as a skin rash.

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But about two in 100 travelers who purchase insurance do experience more serious incidents — medical issues that appear while they are traveling that they weren’t aware of before, or accidents while in transit, particularly on motorcycles, Sylvester said.

“We’re wound up so tight, you unwind some time and you find out you’re not just stressed at work. You’re actually sick,” he said.

Robert Quigley, a cardiovascular surgeon and senior vice president of International SOS, which offers medical and travel security risk services to individuals and companies, said travelers suffer health problems for a variety of reasons: They engage in activities they don’t normally do, take more risks, try new foods and drink more than usual, making people with preexisting conditions vulnerable to medical complications, he said.

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But at first glance, he said, the reported deaths in the Dominican Republic did seem to potentially indicate a cluster that was not entirely explainable by natural causes, noting that some of the victims were relatively young.

“It could raise some concern,” he said, “but until there’s forensic data, no conclusions can be made.”

Rosenberg reported from Washington. Faiola reported from Miami. Lindsey Bever, Alex Horton and Maite Fernández contributed to this report.