CLEVELAND-- A former New York pizzeria owner Vittorio Caruso mysteriously died in the Dominican Republic over the weekend.
It's at least the 10th time in the past 13 months that an American death is linked to the Caribbean nation.
Family members said Caruso died after falling victim to respiratory distress.
Dominican Republic officials have said the 10 traveler deaths are isolated deaths.
Still, local travel agencies are feeling the heat.
"Every time an article comes out they call and want reassurance from us," said Angie McClure, owner of Cleveland’s Canary Travel.
McClure said they have been juggling clients’ concerns and in some cases, canceling trips or changing destinations.
Canary said as long as a client has traveler’s insurance, changes can be made free of charge.
"We can't guarantee anybody's safety. That's not what we're here for. We will change them if they're not comfortable with the destination. I have a destination leaving tomorrow, and they're all ready to go," McClure said.
In several cases, the victims' reportedly took drinks from minibars before quickly falling ill and later dying.
The U.S. State Department reported last week that statistics indicate the threat to American tourists in the DR might be overblown, with the death rate 7.04 per every 1,000 people for the last decade.
“We want to make sure that our clients are safe. That's first and foremost and I certainly would not send anybody anywhere I don't feel comfortable myself going," McClure said.