The left-arm spinner has been prescribed medication for a throat infection and is isolated from the rest of the squad.
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"He is the one concern we have got at the moment," coach Duncan Fletcher told reporters.
England have been boosted though by the news that former captain Nasser Hussain, who missed the first Test because of a similar viral infection, is available to return.
But Hussain's replacement Paul Collingwood batted defiantly for nearly three hours in Galle and England now face a selection headache.
The England coach and his Sri Lanka counterpart John Dyson are both claiming to have earned a psychological advantage from the drawn first Test.
Fletcher believes the tourists have gained momentum for the match in Kandy after his tail-enders batted through the last two hours to finish on 210 for nine in Galle.
"I think we have gained a big advantage," Fletcher said. "It would have been a huge blow to us if we had lost right at the death.
"To have fought for five days and to lose at the end would have been very difficult to come back from. It was a tremendous achievement. If you win the toss there you should basically win the game and good sides have gone out there and been thrashed."
But Dyson argued that Sri Lanka would take confidence from the draw.
"The boys would have been very pleased with a win but we were the dominant team in the match and morale is very good," Dyson said. "We gave England a good whacking in (the one-day international in) Dambulla and in the test match they were never in the game.
"We were the only team that looked like winning. The way England are playing we now have a good chance."
