People clean a monument featuring North Korea's founding father Kim Il-Sung in central Pyongyang. The tour agency that took US student Otto Warmbier to Pyongyang says it will stop taking Americans to the reclusive state

The death of US student Otto Warmbier following his incarceration in North Korea has shaken tour companies crew catering to thrill seekers, with several reconsidering whether to take Americans to the reclusive state.

Warmbier, 22, died Monday after being medically evacuated to the United States last week suffering from severe brain damage, with US President Donald Trump blaming Pyongyang's "brutal regime" for his plight.

Young Pioneer Tours, the China-based travel agency that took Warmbier to North Korea, said in a Facebook post that it would no longer allow US citizens on its trips.

Three other Western travel companies also issued statements saying they were reviewing whether to take Americans on future North Korean tours.

"We have been struggling to process the result," said Young Pioneer Tours, which advertises the North as "probably one of the safest places on Earth to visit".

The University of Virginia student was arrested at the airport as he was leaving Pyongyang in January last year and sentenced at a show trial to 15 years of hard labour for stealing a political poster from a hotel.

"There had not been any previous detainment in North Korea that has ended with such tragic finality," the company said.

Warmbier was arrested at the airport as he was leaving Pyongyang and sentenced at a show trial to 15 years of hard labour

The agency, founded in 2008 by a British expat, came under fire after Warmbier was flown home in a coma following a flurry of secret diplomatic negotiations between Washington and Pyongyang.

"They advertise it's the safest trip ever and, you know, it's the one your mother wouldn't want you to go on. But what they do is they provide fodder for the North Koreans and my son happened to become fodder for the North Koreans," his father Fred Warmbier said last week.

Tourists wanting to travel to the North must go with a tour company. Americans are required to fly to Pyongyang from Beijing, while other nationalities are allowed to go by train. But the US State Department strongly warns Americans against travelling there.

- 'Binge drinking' -

Adam Pitt, a Briton who travelled with Young Pioneer Tours to North Korea in 2013, told AFP he was given "very little warning" about the potential risks of going to the North.

"It became apparent very early on in the trip that the culture was very much what you'd expect to find on a binge-drinking destination in the Mediterranean," said Pitt, highlighting "lewd jokes" and "all-night drinking" by members of his group.

But the company, which promises to take adventurous travellers to destinations such as Chernobyl and Iran for "as cheap as possible", has a five-star rating on TripAdvisor and several posts on Facebook praised it.

Emails and calls to Young Pioneer Tours' office in the central city of Xian and mobile numbers went unanswered.

- 'Devastating tragedy' -

Several thousand international tourists are thought to travel to North Korea every year, as well as tens of thousands of Chinese travellers.

Young Pioneer is one of a handful of firms that cater to the international market, offering activities including scuba diving and cycling in one of the world's most impoverished countries.

Warmbier was alleged to have removed a political poster from staff quarters at the Yanggakdo International Hotel in Pyongyang

China-based Koryo Tours, which has been going to North Korea since 1993 and takes about 2,000 tourists a year, said the "devastating tragedy" had prompted it to reconsider taking US citizens to the North.

UK-based Lupine Travel managing director Dylan Harris told AFP that the company which takes in 600 travellers annually was also reconsidering whether to cater to Americans, "but for all other nationalities there will be no change".

Uri Tours, which is based in the United States and has an office in Shanghai, said it was "reviewing" its position.

The North claimed Warmbier fell into a coma soon after he was sentenced last year.

Medical tests carried out in the United States dispute North Korea's claim that he had contracted botulism but the cause of his brain injury remain unclear.

Three more US citizens are currently being held by the North. Two were teachers at a Pyongyang university funded by overseas Christian groups, and the third is a Korean-American pastor who was accused of espionage for the South.

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