Communicating about infectious disease threats: Insights from public health information officers

•Infectious disease threats in a dynamic communication environment bring new challenges for public health information officers (PIOs).•Different types of infectious diseases prompt the need for communication in different ways.•There are many structural and institutional issues affecting the performance and effectiveness IDT communication.•Infectious disease threat messages, materials, and recommendations sent by PIOs need to be trusted in news media engagement.•PIOs and health agencies need to strategically integrate traditional, social, and online media in doing infectious disease communication. The public health communication challenges that arise in times of infectious disease threats (IDTs) were examined using the Risk Amplification through Media Spread (RAMS) Framework and in-depth phone interviews with 40 national, state, and local public health information officers (PIOs). Interviewees shared their experiences and insights related to how IDTs are communicated to the public, including the different types of traditional and social media used, how they develop and assess IDT messages, and their perceptions regarding the IDT risk amplification process. Theoretical and practical implications for health public relations and public health communication are discussed.