The Oranje might not be able to face their last-16 opponents with a full squad.
Louis van Gaal has confirmed several Netherlands players have flu-like symptoms ahead of their match against the USA.
Netherlands claimed a 2-0 win over Qatar on Tuesday to reach the knockout stage as the Group A leaders.
Van Gaal’s side are preparing to meet the USMNT in the next round. But the Dutchman says Netherlands’ fitness status is not ideal ahead of the game.
“We are not going to elaborate on that but if it goes around in the group, it is worrying,” Van Gaal said on Friday.
“There are not fifteen or so [affected]. In principle, everyone is fit and available.”
Spain and Brazil have also reported having a few players with similar symptoms in recent days.
Many observers have speculated the situation might be a result of using the pitch-level air conditioning units in the World Cup stadiums.
Brazil’s Antony was among a few players who spoke out against the air conditioning system.
“It was a bit difficult,” the Man Utd star said. “I ended up having a bad feeling there for a few days that complicated me a bit.
“I’m recovering well and getting 100 per cent. It was more of a sickness, throat. It was the air conditioning (in the stadiums).
“Not only me, but other players also had a cough and a bad throat. It’s very difficult for me to get sick, but I’m happy to be an important part of the team. Whenever you need Antony, I’m available.”