The State Department confirmed to TIME that 46-year-old Denver resident, Khalid Adkins, died in the Dominican Republic on June 25, raising the number of U.S. tourist deaths in the Caribbean country in 2019 to 11.

Amid the headlines about tourist deaths, Delta Airlines announced it would allow passengers with tickets to Punta Cana, where at least three U.S. tourists have died––to cancel or reschedule their flights “due to recent events.”

Delta passengers who purchased tickets to Punta Cana airport before June 21 have until Aug. 15 to reschedule their flights to any date on or before Nov. 20, without being charged a change fee.

Passengers who choose to cancel their flights entirely have a year from the booking date to use the credits.

Last week, Hard Rock Hotel & Casino announced it would be removing liquor dispensers from all guest rooms at the Punta Cana location, along with other safety measures. In a statement, the hotel clarified that it was doing this based on “guest feedback” and to “enhance safety moving forward,” not due to reports that some U.S. tourist deaths may have been caused by tainted alcohol. Neither U.S. nor Dominican officials have confirmed reports that authorities were investigating tainted alcohol.

According to Hard Rock, in addition to removing the liquor dispensers, all alcohol on the property will be brand-name and sourced from the U.S. except speciality drinks from the Dominican Republic, including Presidente beer.

Additionally, Hard Rock’s Punta Cana location will hire a U.S.-based healthcare facility and will contract a U.S.-based 3rd party testing lab to inspect and test all food and beverages.

The headlines about American tourists dying and have fueled speculation among travelers that the Caribbean country is an unsafe destination for travelers.

Safety concerns began to arise in May, when three seemingly healthy American tourists suddenly died in the same resort within the same week. The FBI has confirmed that it is assisting Dominican police with the investigations. The State Department said there has been no evidence of foul play and no sign that the deaths are connected.

Despite the tragic headlines, safety experts are cautioning travelers not to rush to conclusions. The connections, they say, are not immediately apparent and safety experts in particular say that the country is no more dangerous than it was before.

“It’s not an overly dangerous place,” Matthew Bradley, a former CIA agent and current Regional Security Director of International SOS, a travel security company, tells TIME. “I would still consider the Dominican Republic a safe place to go.”

According to the State Department, last year 13 U.S. citizens died while traveling to the Dominican Republic. The number was 17 in 2017. More than 2.7 million U.S. tourists visited the island in 2017, making the island the fourth most popular travel destination for Americans.

In a statement, a State Department spokesperson tells TIME that there has not been an increase in the reported deaths of American tourist in the Dominican Republic.

“We have not seen an uptick in the number of U.S. citizen deaths reported to the Department,” the statement said.

But for those millions of travelers with trips booked, police and resort officials are asking the public to wait for conclusions from investigations before making assumptions — and denying there is anything nefarious at play.

11 American tourists have died in the Dominican Republic this year

This year there have been multiple high-profile cases involving American tourists dying while staying in the Dominican Republic. Seven deaths have been attributed to tourists becoming ill and dying of health related issues.

Khalid Adkins

According to the GoFundMe page started by his sister-in-law, Marla Strick, Adkins traveled to the Dominican Republic with his daughter last week when he suddenly became sick. During his flight back to Colorado on Sunday, Adkins became ill on the plane, vomiting, and was forced to go to a hospital in Santo Domingo.

Strick confirmed Adkins died on Tuesday and his family is raising funds to cover cost for him to return home. As of Thursday, the fundraiser has raised $21,903 out of it’s $20,000 goal.

“We need to get his body home anything helps please!!,” Strick posted. “We really want to know what happened! We just want to get his body home to hopefully get some answers.”



Jerry Curan

Curran, 78, died on Jan. 26 just days after traveling to the DR with his wife, according to NBC affiliate WKYC.

The family is suspicious about the death after Curran threw up and was unresponsive shortly after he and his wife had dinner the night they arrived, WKYC reports.

He was staying at the Hard Rock Hotel & Casino in Punta Cana.

“We want to find out what happened and why did he die,” Kellie Brown told WKYC.

Orlando Moore and Portia Ravenelle

In April, the bodies of New York City couple Orlando Moore, 40, and Portia Ravenelle, 52, were found after being reported missing for weeks. Dominican authorities confirmed that the couple died in a car accident in Santo Domingo.

Robert Wallace

Relatives of Wallace, 67, told Fox News that he had died after visiting the Hard Rock Hotel & Casino Resort in Punta Cana. His niece Chloe Arnold told Fox that on April 11, Wallace fell ill after having a Scotch from his hotel room’s mini bar. After being checked by a hotel doctor on April 13, Wallace was sent to the hospital where he died on April 14.

Arnold described her uncle as an avid traveler in good health. His obituary says he passed “unexpectedly while vacationing in the Dominican Republic.”

Arnold told Fox that Dominican authorities have not yet confirmed her uncle’s cause of death.

“We have so many questions,” she said. “We don’t want this to happen to anyone else.”

Miranda Schaup-Werner

Schaup-Werner, 41, was found unresponsive by hotel staff in her Luxury Bahia Principe Bouganville resort hotel room on May 25. According to the hotel, which is located in San Pedro de Macoris, Dominican authorities concluded she had suffered a heart attack. In a statement, Bahia Principe said her husband, who Schaup-Werner was traveling with, confirmed she had a history of heart conditions.

Cynthia Day and Nathaniel Holmes

Five days after the death of Schaup-Werner, Day, 49, and Holmes, 63, a couple from Maryland were found in their hotel rooms, unresponsive. They were staying at the Grand Bahia Principe La Romana, which is less than a mile away from sister resort Luxury Bahia Principe Bouganville where Schaup-Werner was staying. The case is still under investigation and there were no signs of violence in the case, according to the resort.

Leyla Cox

Leyla Cox, 53, was found dead in her hotel room on June 11 while staying at the Excellence Resort in Punta Cana.

“I am overwhelmed and confused and in shock,” William Cox, 25, Leyla’s son told the Staten Island Advance. “Her birthday was June 9 and she passed away on June 10.”

Joseph Allen

Allen, a New Jersey native, died while vacationing in the Dominican Republic, a State Department spokesperson confirms to TIME. Allen was found dead in his hotel room at Terra Linda Sosua on June 13, according to WABC in New York.

Jamie Reed, his sister, told WABC that her brother was celebrating a friend’s birthday and regularly visited the area.

“We didn’t think anything of it, because he does this all the time,” she told WABC.

Vittorio Caruso

Caruso, 56, died on June 17 after staying at the Boca Chica Resort in Santo Domingo.

His family told Fox News that he had been traveling by himself and he was in good health.

His sister-in-law, Lisa Maria Caruso, said Caruso was taken to a hospital in respiratory distress after “drinking something.”

The family is still awaiting autopsy reports but said they have been told “conflicting stories from different people” about the circumstances surrounding Caruso’s death.

Other high-profile incidents

David Ortiz, the former Red Sox slugger, was ambushed on June 9 while sitting outside a lounge bar in Santo Domingo, the Dominican Republic’s capital and largest city. Surveillance footage of the attack shows a motorist approaching Ortiz and opening fire, striking the retired baseball star and others in his group.

Dominican authorities on June 17 identified the man they believe paid hit men to try and kill Ortiz, adding that they were closing in on the mastermind and motive behind the shooting, the Associated Press reported. Authorities have 10 people in custody related to the shooting and are looking for at least two others.

Dozens of members of the Central Oklahoma Parrothead Association, a group for fans of Jimmy Buffet and trop rock, say they fell “seriously ill” days into their stay at the Hotel Riu Palace Macao in Punta Cana in April.

Dana Flowers, a member and the travel agent, tells TIME that 47 of the 114 members traveling with the group got sick almost immediately, including him.

“It was as bad as it gets,” he says.”Three days in we started noticing people did not make it to concerts and events, it was then we realized they were all sick. It all happened pretty quickly and in pretty good numbers, it was obvious that something is not right. We all thought it was food poisoning and so we went with that, you know this kind of thing happens occasionally, but then the numbers grew and we knew it was a serious issue.”

Flowers says a few members of the group visited the resort’s doctor who gave patients medication for parasites.

RIU Hotels & Resorts, where the group, stayed tells TIME that doctors at the hotel treated three patients for gastroenteritis and were not able to determine the source of their stomach flu.

How safe is the Dominican Republic?

State Department issued a level two (out of four) safety warning for the Dominican Republic in April 2019. The warning advises travelers exercise increased caution due to violent crime in the country, which include armed robbery, homicide and sexual assault. The State Department says that resort areas tend to be better policed and safer that urban areas for travelers.

Bradley, the International SOS analyst, says there is likely a reasonable explanation for the spate of tourist deaths.



“It’s the mystery around the deaths that is driving the speculation,” he tells TIME. “American tourists pass away frequently around the world, several in a day, it’s not unusual. But it is unusual hearing about Americans passing away abroad without it being something like a terrorist attack. We usually don’t hear about tourists dying of heart attacks or in their sleep, but that happens everyday with tourist traveling abroad, it is nothing unique to the Dominican Republic.”

He says prospective travelers who are concerned about the recent deaths, should make sure they have a plan for what to do if they get ill. Bradley suggests travelers should have the phone number for the best nearby hospitals and should check with their insurance providers to make sure they will be covered while traveling. He says travelers can ask hotels whether they offer on-site medical assistance. Travelers can also make arrangements to get immediate medical care back home if they have to leave unexpectedly.



“I don’t think people should distrust Dominican officials,” he adds. “They’re working with what they have. Like they said, 2 million Americans visit DR (Dominican Republic) every year and only a handful have died.”

Bradley says he would advise anyone worried about traveling to the Dominican Republic to take the same precautions they would when going anywhere else.

“These incidents, while recent, in my mind don’t indicate Dominican Republic is any less safe than it was before,” Bradley says. “I would tell people to continue with trips.”

Considering the level two safety ranking from the State Department, Bradley advises travelers not to go anywhere alone, especially at night. And if you do wander on your own, Bradley says, let a companion know when you plan on returning so they can be aware something is amiss if you do not return. “Travel has risk,” Bradley says. “People should be aware before they travel where they are going and plan accordingly, if they do, they usually travel safely.”

Dr. Robert Quigley, Senior Vice President and Regional Medical Director of International SOS says travelers should take extra precaution with their health when away from home.

He advises travelers to visit a doctor prior to embarking on their trip, especially if they might have a chronic medical condition or cardiovascular disease. Quigley says sleep deprivation and stress can “exacerbate underlying, and sometimes asymptomatic, serious cardiovascular diseases.”

He also advised travelers to pack extra medication in case their trip home is delayed.

Will tourism in the Dominican Republic be affected?

As the stories continue to emerge, some travelers have taken to social media to voice concerns about traveling to the Caribbean country. While officials at the Dominican Ministry of Tourism told TIME they were not able to elaborate on the situation because of the ongoing investigation, Francisco Javier García, the Minister of Tourism for Dominican Republic said that the investigations are not affecting the number of tourist visiting the country.

“These cases are very regrettable, but isolated.” he said at a press conference in June. “Investigation into them is a top priority for us and for the National Police. We are asking them to deploy all resources to help provide answers as quickly as possible.”

He called the Dominican Republic a “tranquil, peaceful destination and the safest in the region,” and said tourists can “be assured that the authorities are working hard to clarify these incidents.”

Despite the reassurance, some travelers are saying the incidents have cast doubt on the safety of the country and are refusing to take a chance.

Correction June 27

The original version of this story misstated the Dominican Republic’s largest city. It is Santo Domingo, not Punta Cana

Write to Gina Martinez at gina.martinez@time.com and Josiah Bates at josiah.bates@time.com.