Another US tourist has died in the Dominican Republic, bringing to eight the number of Americans to die in the country over the past year.
Leyla Cox, 53, died June 10 in her hotel room, Excellence Resorts in Punta Cana confirmed to CNN on Sunday.
Officials in the Dominican Republic have called the deaths isolated events as they work to reassure travelers their country is safe.
"In the last five years, over 30 million tourists have visited the Dominican Republic, but this is the first time the international media report such an alarming situation," Tourism Minister Francisco Javier Garcia said earlier this month. "These are isolated incidents and the Dominican Republic is a safe destination."
Previously, the hotel told CNN that Cox felt unwell and was taken to the hospital. But in a Sunday statement the resort said Cox, of Staten Island, New York, died in her hotel room.
The hotel gave the cause of death as heart attack, citing a forensics report. CNN has not independently confirmed the contents of the report.
"We are deeply saddened by the recent incidents in the Dominican Republic," the hotel's statement said. "We understand that safety is a paramount concern for all travelers and we have always taken extensive measures to make safety a priority of all of our Excellence Punta Cana guests."
Excellence Resorts says it is cooperating with local and US authorities and expressed "sincere condolences to all of those affected by the recent incidents."
"We will strive to continue to provide outstanding services to our customers, with their safety and security top of mind."
Cox's son expressed doubts over the hotel's claims about his mother's cause of death, saying he did not believe she died from "natural causes."
"I truly believe if she was anywhere else in the world besides the Dominican Republic she'd be alive right now," Will Cox told CNN affiliate WCBS.
"I just hope for some answers."
Officials say Dominican Republic still safe
Dominican Republic leaders maintain the country is one of the region's top tourism destinations -- with more than 6 million tourists last year -- 2.2 million of them Americans, according to the Caribbean Tourism Organization.
Government spokesman Roberto Rodriguez Marchena put out a video calling it the "largest, fastest growing, tourism destination of the Insular Caribbean."
"Cheerful, welcoming and hospitable, our Dominican Republic, the economy that grows the most in America, with its beautiful beaches and mountains, its tasty gastronomy and hardworking people invites you to know and love it," he said in a tweet last week.
The spokesman said 14 million Americans have visited since 2012.
From 2012 to December 2018, 128 Americans have died there, according to statistics available on the US Department of State website. The statistics, which do not cover deaths from natural causes, include drownings, homicides, suicides, vehicle and other accidents.
The department has not issued a travel warning and American officials have not said the deaths were connected.
"The safety and security of U.S. citizens that live in, work in, and visit the Dominican Republic remains our highest priority. These incidents are tragic and we offer our deepest condolences to those personally impacted," the State Department said.
Matthew Bradley, regional security director for the risk management firm International SOS, said in a statement this month that the Dominican Republic is still a safe destination.
"These incidents, while recent, in my mind don't indicate Dominican Republic is any less safe than it was before," Bradley said. "I would tell people to continue with trips."
Seven other Americans died in three resorts
On May 30, staff at the Bahia Principe La Romana found Edward Nathaniel Holmes, 63, and Cynthia Day, 49, dead. The couple had internal bleeding, including in their pancreases, Dominican authorities said. Holmes had an enlarged heart and cirrhosis of the liver -- both signs of significant pre-existing disease, the Dominican authorities said, and Day also had fluid in her brain.
The couple also had fluid in their lungs, Attorney General Jean Alain Rodriguez Sanchez's office said in a statement. Authorities wouldn't provide more details on the cause of death until toxicology results are completed.
Miranda Schaup-Werner checked into the same resort on May 25, where she shared a room with her husband, Dan Werner. She had a drink from the minibar and suddenly felt ill, family spokesman Jay McDonald told CNN affiliate WFMZ. Shortly afterward, she collapsed and died.
Schaup-Werner suffered from a heart attack, pulmonary edema and respiratory failure, according to a preliminary autopsy cited by the Attorney General's Office of the Dominican Republic.
Businesswoman and "Shark Tank" TV star Barbara Corcoran said her brother died in his hotel room in the Dominican Republic in late April. John Corcoran "passed away from what is believed to be natural causes," she said in a statement.
On April 12, 67-year-old Robert Wallace died after becoming ill at the Hard Rock Hotel & Casino in Punta Cana, relatives told CNN affiliate KTXL-TV.
"While we are deeply saddened by these incidents, and our thoughts go out to all of those affected, we, along with the general public, will be monitoring the facts as they unfold surrounding these events," the hotel said in a statement.
Last July, David Harrison, 45, died at the same hotel, according to his wife, Dawn McCoy. She said her husband returned from a snorkeling excursion one day earlier and he said he wasn't feeling well. Early the next morning, she said, he was sweating and unable to get up before he died. The cause of death was listed as a heart attack and pulmonary edema by local authorities.
And in June 2018, Yvette Monique Sport died at the Bahia Principe in Punta Cana, her sister, Felecia Nieves, told CNN. She had traveled there with a group of friends, her first vacation in eight years, Nieves said.
Sport took a shower and went to bed after having drinks with her fiance, Nieves said. Sport also had a drink from the minibar, she said. Her fiance heard her make "a gurgling sound" in her sleep, Nieves said. The next morning, Nieves said he discovered that she was dead. The family is still awaiting toxicology reports.