Paula Radcliffe has pulled out of Saturday's View From Great North Cross Country in Newcastle after suffering a bacterial infection.
Radcliffe's manager and husband Gary Lough informed Peter Elliott, the elite athlete co-ordinator for the meeting, of her decision this morning.
It is the third major blow in a week for the meeting after Ethiopians Deratu Tulu and Gete Wami also vacated their starting slots, fighting lack of form and injury.
Lough said: "She is disappointed at having to pull out because she was looking forward to racing in front of the crowds in Newcastle."
Elliott, already chasing suitable replacements for the Ethiopians, is now involved in a race against the clock to sign a world-class substitute for Radcliffe.
The former Commonwealth Games 1,500metre gold medallist said: "Of course I am disappointed but what can you do? Paula is a highly experienced athlete and knows what is best for herself.
"Now I have to pull out all the stops. It is going to be a very busy day for me."