West Ham United midfielder Declan Rice has been forced to withdraw from the England squad for November's World Cup 2022 qualifiers due to illness.
Gareth Southgate has already lost Marcus Rashford and James Ward-Prowse so far, while Mason Mount and Luke Shaw are also yet to link up with the team.
Rice - who has played every minute of Premier League football for West Ham so far this term - was expected to play a key role in November's games with Albania and San Marino.
However, the Three Lions have now confirmed that the 22-year-old will play no part in this month's qualifiers after coming down with a bug, which has prevented him from taking part in training.
Southgate has not planned to call up any replacements yet, and the latest squad update also revealed that Mount (dental) and Shaw (concussion) are still being assessed.
Rice - a 27-cap international - has three goals and three assists from 15 appearances in all competitions for the Hammers this term.