Stuart Broad, Jofra Archer and Jack Leach will all miss day one of England's final warm-up match in South Africa with an ongoing illness.
The trio already sat out the initial two-day workout against an Invitational XI and have not been passed fit to travel to the ground in Benoni for the start of the three-day clash with South Africa A.
England had already successfully appealed for the game to be downgraded from first-class status due to the bug sweeping their camp, meaning the trio could still play some part as the fixture progresses.
South Africa have had a setback of their own, with batsman Temba Bavuma ruled out of the Boxing Day Test at Centurion.
Bavuma was also due to feature in the South Africa A game by way of preparation for the series but scans have revealed a grade one strain in his hip.
Cricket South Africa hope he will be back to play the second Test in Cape Town and will nominate a replacement after this weekend.
The team's chief medical officer, Dr Shuaib Manjra, said: "Temba Bavuma presented with clinical features of a left hip flexor strain. A scan done yesterday confirmed a Grade One strain of one of the hip flexor muscles. Temba will commence his rehabilitation program with a goal of returning to play in seven to 10 days' time."
