According to an IGN report, the North American boxart proposed by publisher Deep Silver has been censored by the ESRB. The rejection was due to a zombie / corpse hanging from a palm tree that represented the "I" in "Island." The approved box art simply uses a standing zombie as the "I" and removes the noose / hanging scene from the equation.
The in-game logo will remain unchanged and the boxart and in-game logo for Dead Island in Europe will remain unchanged, according to the IGN report. Dead Island is currently scheduled for release for an undetermined date in 2011.
Thanks to Andrew Eisen for the tip.