The news out of the Dominican Republic just keeps getting stranger. Following a slew of American tourist deaths in resorts throughout the country, the questions began piling up.
Here's what we know about the recent deaths - and what we still don't know.
1. How many Americans have died under mysterious circumstances in the Dominican Republic this year?
According to news reports and the U.S. State Department, seven Americans have become ill and died this year in the Dominican Republic, under circumstances that are prompting questions. The first, 67-year-old Robert Bell Wallace from California, died unexpectedly after getting sick at the Hard Rock Hotel & Casino in Punta Cana on April 14, a family member told Fox News. The family member said Wallace became ill after drinking a scotch from the minibar.
The next three deaths came in late May and more than an hour southwest from the Hard Rock, at neighboring resorts on the southern coast that shared an owner. Miranda Schaup-Werner, a 41-year-old from Pennsylvania, checked into the Luxury Bahia Principe Bouganville on May 25 and started to feel sick after taking a drink from the minibar. She died within a couple of hours.
Maryland residents Cynthia Ann Day, 49, and Nathaniel Edward Holmes, 63, were supposed to have checked out of the neighboring Grand Bahia Principe La Romana on May 30 when a hotel worker found them dead in their room.
Late last week, family members of two other people who died in Punta Cana this year raised questions publicly about their deaths. Family members told WKYC in Ohio that 78-year-old Jerry Curran, a retiree who lived in Florida, died in January after falling ill on the island. The U.S. State Department confirmed that a Staten Island woman, Leyla Cox, died June 11. Her son told NBC News that he questioned the ruling that his mother, who was 53, died of a heart attack.
And on Monday, the sister of 55-year-old Joseph Allen, of New Jersey, told ABC he was found dead in his room June 13 at the Tierra Linda Resort in Sosua, on the country's northern coast.
2. What caused the deaths?
Officials have not said what caused Wallace's death; his stepson said that family members are expecting toxicology reports by the end of June.
Government officials said June 6 that autopsy results showed that Schaup-Werner, Day and Holmes all had enlarged hearts, internal bleeding and pulmonary edema, or fluid in the lungs. According to the hotel, Schaup-Werner's husband said she had had a heart condition. But a family spokesman told Fox News she had been treated for an issue 15 years ago and was healthy ever since. Prescription drugs, including blood pressure medication and five-milligram doses of the painkiller oxycodone, were found in the room that Day and Holmes had been staying in.
More information will be known when results of toxicology tests, which check for drugs, alcohol, poison and other toxic substances in the body, are available.
3. How long will those tests take?
In the United States, comprehensive toxicology results are usually available in approximately two weeks, according to Laura Labay, a forensic toxicologist and director of toxicological services at NMS Labs in Pennsylvania. But depending on what the results show and how much more testing needs to be done, she says that time frame could expand into six to eight weeks - which means family members might still be waiting for answers in late July.
Labay says that if tests show a positive result for some kind of drug or other substance, then that would need to be confirmed through additional testing. And an initial negative result could prompt further analysis. "If you have a case where you suspect it's some kind of drug or chemical exposure that's caused a death and the initial round is negative, you probably will go on to do more specialized testing."
4. Didn't other tourists claim they got sick, too?
Many have, and more seem to be cropping up every day. A couple from Colorado - 29-year-old Kaylynn Knull and 33-year-old Tom Schwander - told CNN they got terribly sick during a visit to the Grand Bahia Principe La Romana in June of last year. They have since sued the hotel's ownership, claiming they were exposed to chemicals typically found in pesticides, CNN reported. Visitors from Georgia, Florida, Pennsylvania and New York have also told news outlets that they got sick at resorts in the country between June 2018 and May of this year. The site iwaspoisoned.com includes recent claims from more than 1,000 users who said they got sick in the Dominican Republic, though some of those cases dated back months or even years.
Family members of at least two other people who died in the country of heart attacks in June and July of last year have also come forward since hearing news of the recent deaths. Another Pennsylvania woman, 51-year-old Yvette Monique Sport, died unexpectedly in June of last year during her stay at a Bahia Principe resort in Punta Cana, her sister told WTFX Fox 29. The sister, Felecia Nieves, said the official cause of death was listed as a heart attack; Sport drank from the minibar before she died, Nieves said.
And Brandywine, Maryland, resident Dawn McCoy told The Washington Post her husband, David Harrison, died at the Hard Rock in Punta Cana - the same place Wallace fell ill - in July of last year. He had a heart attack, but an autopsy showed he also had fluid in his lungs, as did the three tourists who died most recently.
5. What are U.S. authorities doing?
The FBI confirmed that it is "assisting the Dominican authorities with their investigation." According to the U.S. Embassy in the Dominican Republic, local authorities asked for FBI help for "further toxicology analysis on the recent Bahia Principe, La Romana cases" - results that the FBI said could take up to 30 days.
"The U.S. Embassy in Santo Domingo is actively working with the Government of the Dominican Republic and the private sector at the highest levels to ensure that U.S. citizens are safe and feel safe while in the Dominican Republic," the embassy said in a statement.
The State Department also said representatives helped officials in the Dominican Republic get in touch with the families of Day and Holmes and arrange for their bodies to be sent back to the United States.
6. Is the Dominican Republic safe for tourists?
According to the U.S. State Department, Americans should use increased caution because of crime. The country is ranked as a "Level 2" out of four under the advisory system for foreign destinations.
"Violent crime, including armed robbery, homicide and sexual assault, is a concern throughout the Dominican Republic," a travel advisory says, noting that resort areas tend to have more of a police presence than urban areas such as Santo Domingo. "The wide availability of weapons, the use and trade of illicit drugs, and a weak criminal justice system contribute to the high level of criminality on the broader scale."
The State Department also warns travelers not to drink alcohol alone or with new acquaintances, or to leave drinks unattended. It also cautions that U.S. citizens have been the targets of "date rape drugs" at parties and resorts.
Meanwhile, two recent high-profile crimes have drawn fresh scrutiny. David Ortiz, the retired Boston Red Sox player, was shot and wounded June 9 in Santo Domingo. And Delaware resident Tammy Lawrence-Daley, 51, reported that she was viciously beaten at a Punta Cana resort in January. The property, the Majestic Elegance Punta Cana, has questioned her account.
Experts have urged travelers not to avoid the country, arguing that a handful of cases shouldn't taint the entire destination.
7. How safe has the country typically been for U.S. visitors?
Between the beginning of 2017 and the end of 2018, 30 Americans died in the Dominican Republic of non-natural causes, according to the State Department. Those deaths were caused by drowning, accidents, suicide and homicide.
Last year, nearly 6.6 million people visited the country; more than 2.3 million of those were from the United States.