Harlequins winger David Strettle has been ruled out of England's first test match against South Africa in Bloemfontein on Saturday (2pm GMT, live on SkySports 2) through illness.
Iain Balshaw comes in for Strettle as a straight swap on the right wing, with the Gloucester back's place on the bench to be announced on Friday.
Brian Ashton said: "I obviously feel for David as it's his first senior England tour but Iain is an experienced player and will do a good job for us.
"I'll consider my options on the bench over the next 24 hours and I expect to make an announcement after training at Vodacom Park tomorrow afternoon."
England team doctor Simon Kemp said: "David's vomiting continued through yesterday and he was unable to take fluids by mouth.
"He was admitted to a local hospital for rehydration and monitoring and while he has made good progress overnight he will not be fit to play on Saturday."
Andy Farrell (Saracens) was also advised to have further rest today and didn't train but he is making good progress from his virus.
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